Cytogenetics and Cytogenomics Laboratory

Test name Consent Form Requisition Form Additional Information
Chromosome Analysis

Peripheral Blood Chromosomes and FISH Consent [PDF]

Chorionic Villus Consent [PDF]

Amniotic Fluid Consent [PDF]

Abortus Tissue Consent [PDF]

General Test Requisition [PDF]  
FISH, ANEUPLOIDY FISH Panel Aneuvysion Consent [PDF] General Test Requisition [PDF]  
FISH, STAT FISH Panel + Chromosome Analysis Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, POC FISH Panel Abortus Tissue Consent [PDF] General Test Requisition [PDF]  
FISH, Prenatal Microdeletion Panel Microdeletion Panel Consent [PDF] General Test Requisition [PDF] Microdeletion Panel Infosheet [PDF]
FISH, 1p36 Deletion Syndrome Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, Angelman Syndrome Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, Cri-du-chat Syndrome Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, DiGeorge/Velo-Cardio-Facial syndrome Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, Miller-Dieker Syndrome Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, Prader-Willi Syndrome Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, Smith-Magenis Syndrome Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, Williams Syndrome Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, Wolf-Hirschhorn Syndrome Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, SRY Analysis Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, STS Analysis Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
FISH, Kallmann Syndrome Analysis Peripheral Blood Chromosomes and FISH Consent [PDF] General Test Requisition [PDF]  
Array Comparative Genomic Hybridization (aCGH), Postnatal, 2x105K ISCA Design Postnatal Array Consent [PDF] General Test Requisition [PDF]

Postnatal Array List of Diseases [PDF]

Postnatal Array Physician Infosheet [PDF]

Array Comparative Genomic Hybridization (aCGH), Prenatal, 4x44K Custom Design Prenatal Array Consent [PDF] General Test Requisition [PDF]

Prenatal Array List of Diseases [PDF]

Credit Card Authorization Form [PDF]