Patient Information and Signature Forms

Web:	mayocliniclabs.com
Email:	mcl@mayo.edu
Telephone:	800-533-1710
International:	+1 855-379-3115
Values are valid only on day of printing

Web:

mayocliniclabs.com

Email:

mcl@mayo.edu

Telephone:

800-533-1710

International:

+1 855-379-3115

Values are valid only on day of printing

Adrenal Mass Panel Patient Information

Biochemical Genetics Patient Information
Bone Histomorphometry Patient Information
Bruton Tyrosine Kinase BTK Genotype Patient Information
Busulfan Information Mail-In Specimen Instructions

Chimerism Analysis Information Sheet
Chromosomal Microarray Patient Information
Chromosomal Microarray Prenatal and Products of Conception Patient Information
Coagulation Patient Information
Combined Immunodeficiency, Severe Combined Immunodeficiency, and B-Cell/Antibody Deficiency Patient Information
Congenital Disorders of Glycosylation (CDG, CDGN, OLIGU) Patient Information
Congenital Heart Disease Genetic Testing Patient Information
Congenital Neutropenia, Bone Marrow Failure, Telomere Defects, and Pulmonary Fibrosis (IPF) Patient Information
Connective Tissue/Cerebrovascular Disease Genetic Testing Patient Information
CYP21A2 Gene Testing for Congenital Adrenal Hyperplasia Patient Information
Cytogenetics Tech Only HER2 Paraffin Testing Patient Information

Early Onset Inflammatory Bowel Disease Patient Information
Electron Microscopy Patient Information
Electron Microscopy Technical Only Patient Information
Epidermal Nerve Fiber Density Patient Information
Erythrocytosis Patient Information

Familial Variant Testing Required Patient Information
Family Member Phenotype Information for Genomic Testing
Final Disposition of FetalStillborn Remains
First TrimesterSequential Maternal Screening Patient Information

GATA2 Gene Sequencing Patient Information
Gyn-Cytology Patient Information

Hematopathology Patient Information
Hemophilia A Patient Information
Hemophilia B Patient Information
Hereditary Cardiomyopathies and Arrhythmias Patient Information
Hereditary Dyslipidemia Patient Information
Hereditary Hemorrhagic Telangiectasia and Vascular Malformations Gene Panel Patient Information
Hereditary Renal Genetic Testing Patient Information

Inborn Errors of Immunity, Autoimmunity, and Autoinflammatory Disease Patient Information
Informed Consent for Genetic Testing
Informed Consent for Genetic Testing for Deceased Individuals
Informed Consent for Genetic Testing Spanish

Lead and Heavy Metals Reporting Form
Lead and Heavy Metals Reporting Spanish

Metabolic Hematology NextGeneration Sequencing NGS Patient Information
Metabolic Hematology Patient Information
Molecular Genetics Biochemical Disorders Patient Information
Molecular Genetics Congenital Inherited Diseases Patient Information
Molecular Genetics Hereditary Custom Gene Panel Patient Information
Molecular Genetics Hereditary Hearing Loss Patient Information
Molecular Genetics Inherited Cancer Syndromes Patient Information
Molecular Genetics Neurology Patient Information
Molecular Genetics: Prenatal Patient Information
Molecular Genetics: SERPINA1 Gene Patient Information
Molecular Genetics: Uniparental Disomy Patient Information
Molecular Hematopathology Patient Information
Muscle Histochemistry Patient Information

Nerve Biopsy Patient Information
Noonan Spectrum Gene Testing Patient Information
NTCRL Data for First Trimester Sequential Maternal Screening

PathologyCytology Information
PKLR Gene Sequencing Patient Information
Platelet Antibody Screen Serum Patient Information
Platelet Esoteric Testing Patient Information
Primary Ciliary Dyskinesia Genetic Testing Patient Information
PRKAR1A-Related Disorders Patient Information

Quantitative CMV Immune Competence Assay Patient Information

Rare Coagulation Disorder Patient Information
Renal Biopsy Patient Information
Request for Original Newborn Screening Card

Second Trimester Maternal Screening Alpha-Fetoprotein ⁄ Quad Screen Patient Information

TCR V beta Spectratyping Assay Patient Information
ThalassemiaHemoglobinopathy Patient Information
TREC Assay Patient Information

UGT1A1 Gene Testing Patient Information

Viral Susceptibility, Lymphoproliferation, and Hemophagocytic Lymphohistiocytosis Patient Information
von Willebrand Disease Patient Information

Whole Exome Sequencing Ordering Checklist Patient Information and Informed Consent
Whole Genome Sequencing: Ordering Checklist

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