Genetic Testing Forms

4 forms available. Fill online with BeneFill. Auto-fill from your profile and download completed PDFs.

Genetic Counseling Referral Form

Provider/insurer-specific · Healthcare systems / HMOs

easyDr. sig

Referral for genetic counseling services. Required by HMOs and some PPOs before genetic testing. Genetic counselors provide pre- and post-test counseling.

72% auto-fill10 min saved25 fieldsSubmission guide included

Genetic Testing Lab Requisition

Lab-specific (Invitae, Myriad, Ambry, GeneDx, etc.) · Genetic testing laboratories

moderateDr. sig

Lab-specific order form including clinical indications, family history, insurance information, and patient consent. Labs often handle prior authorization directly.

62% auto-fill17 min saved45 fieldsSubmission guide included

Genetic Testing Prior Authorization

Insurer-specific · Health insurance plans

moderateDr. sig

Request for coverage of genetic tests (BRCA, Lynch syndrome, pharmacogenomics, carrier screening, etc.). Must meet personal and/or family history criteria.

63% auto-fill22 min saved40 fieldsSubmission guide included

GINA Notice (Employer Wellness Programs)

EEOC-compliant notice · Employers

easy

Notice to employees about GINA protections when wellness programs request genetic or family history information. Employers with 15+ employees cannot use genetic information in employment decisions.

80% auto-fill7 min saved10 fieldsSubmission guide included