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HomeServicesRequired Documents

Required Documents

For your facility, please find a list of the test request forms, patient consent and consultation forms and clinical information forms which are required for certain tests performed at Eurofins Biomnis. You can also download these forms directly from our online test guide.

 

Genetics

Prenatal Constitutional Genetics

B3-INTGB – Antenatal diagnostics request form
Download

D31-INTGB – Information and consent for pregnant women
Download

Postnatal Constitutional Genetics

B12-INTGB – Constitutional molecular genetics request form
Download

R23-INTGB – Cystic fibrosis gene analysis (CFTR gene)
Download

D43-INTGB – Declaration of medical consultation and patient consent form for genetic testing.
Download

R36-INTGB – Familial Mediterranean Fever gene study
Download

Pharmacogenetics

K23-24B-INTGB – Evaluation of the toxicity risk of fluoropyrimidines and determination of 5-fluorouracil
Download

D23-INTGB – Declaration of consultation and consent
Download

Constitutional cytogenetics

Pre and Postnatal constitutional cytogenetics

B13-INTGB – Cytogenetics request form
Download

D43-INTGB – Declaration of medical consultation and patient consent form for genetic testing.
Download

Oncology-Haematology

Acquired cytogenetics

B8-INTGB – Malignant Blood Disorders request form.
Download

B9-INTGB – Oncology-Solid tumors request form.
Download

Somatic genetics

B8-INTGB – Malignant Blood Disorders request form.
Download

B9-INTGB – Oncology-Solid tumors request form.
Download

B25-INTGB – Genetic signature test for breast prognosis cancer.
Download

Cellular haematology

B8-INTGB – Malignant Blood Disorders request form.
Download

T21 screening, Pre-Eclampsia and Fœtal Biochemistry

T21 Serum Markers

B2-INTGB – Estimated risk of foetal trisomy 21 request form
Download

NIPT (Non-Invasive Prenatal Testing) Test

B17-INTGB – NIPT Test Request Form
Download

D17-INTGB – NIPT Test Information and Consent Form
Download

Fœtal Biochemistry and Pre-Eclampsia screening

R4-INTGB – Estimated risk of pre-eclampsia through the evaluation of maternal serum markers during the 1st trimester of pregnancy
Download

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