Each test order requires a specific set of forms to be submitted with specimen samples. Forms are included with test kits and can also be downloaded and printed from this page.

If you are using your own sample collection materials, please pay special attention to the sample collection instructions on the form corresponding to the kind of test you are ordering in the Specimen Collection and Processing section.

You will need to complete all forms sent with your test kit for each patient sample, including billing information. Samples cannot be processed until complete and legible information is received.

+Complete Test List
  • Complete Test List
+Test Request Forms
Form Completion Instructions:
  • Instructions for Completion of Test Request Forms
Neurochemistry Test Request Forms:
  • Neurochemistry & Metabolic Test Request Form
Genetic Test Request Forms:
  • Next-Generation Sequencing Test Request Form
  • Single Gene, mtDNA & Repeat Expansion Test Request Form
  • Known Familial Mutation Test Request Form
  • RNA Sequencing Test Request Form
MNG Exome™ and MNGenome® Test Request Forms:
  • MNG Exome™ Sequencing Test Request Form
  • MNGenome® Test Request Form
  • Carrier Exome Test Request Form
  • MNG Healthy Exome™ Test Request Form
Supplemental Test Request Forms:
  • Add-On Test Request Form
  • STAT Testing Order Form
  • Custom Next-Generation Sequencing Test Request Form
  • Sequencing Reassessment Request Form
  • Clinical Information Form
  • Verbal/Unclear Order Form
+Consent Forms
  • Informed Consent for Genetic Testing – NY State Compliant
  • Whole Exome & Whole Genome Sequencing Consent Form
  • Healthy Whole Exome Sequencing Consent Form
  • Carrier Whole Exome Sequencing Test Consent
Spanish Consent Forms:
  • Consentimiento informado para análisis genéticos – En cumplimiento con NY State
  • Consentimiento informado: Secuenciación completa del exoma y del genoma
+Data and Specimen Release Forms
  • Authorization to Release Protected Health Information
  • Specimen Release Form
  • Authorization & Consent for Data Release
+New York State Approval Forms
  • NY State Approved MNG Testing List
  • NY State Non-Permitted Laboratory Test Request Approval Form
+Specimen Collection and Processing Forms
  • Blood and Plasma Collection and Processing Form
  • RNA Sequencing Collection Instructions
  • CSF Collection and Processing Instructions – With and Without MNG Kit
  • Plasma Collection for Phenylalanine Loading Assay
  • Solid Tissue Collection and Processing Form – Genetic Testing Only