Forms you may be asked to complete and return (see also How to make a referral to Clinical Genetics)
External family history questionnaire
Consent to access medical information
Consent to medical photography and publication
Lab documents (see also Requesting genetic testing)
Genetics test request form Non-healthcare professionals are not permitted to request genetic testing.
Cancer leaflets, etc (see also Common referrals and information for patients & professionals)
GMCA Manchester scoring system information leaflet
MSI and BRAF information leaflet
For further information leaflets on BRCA1/2, PALB2, BRIP1, FLCN, FH, RAD51C/D, PTEN, lynch syndrome and chemoprevention in moderate and high-risk women please see the UK Cancer Genetics Group (UKCGG) website: UKCGG leaflets and guidelines – Cancer Genetics Group
UKCGG
The UK Cancer Genetics Group provide useful information leaflets on a number of cancer predisposition genes, including BRCA1/2, PALB2, BRIP1, FLCN, FH, RAD51C/D, PTEN, lynch syndrom,e and chemoprevention in moderate and high-risk women. These leaflets are aimed at health professionals, but they provide information which patients may also find helpful.
eviQ
EviQ is an Australian resource which provides a wide range of information leaflets on cancer predisposition genes and disorders including ATM, BRCA1/2, BRIP1, CDH1, CDKN2A, CHEK2, Lynch Syndrome, Gorlin Syndrome, RAD51C/D, SDHx, TP53, BAP1, Birt-Hogg-Dube Syndrome, PTEN, DICER1, Familial Adenomatous Polyposis, HLRCC, HPT-JT, Juvenile Polyposis Syndrome, MEN1/2, NF1/2, Peutz-Jeghers syndrome, Serrated Polyposis syndrome and VHL.
Prenatal documents, including exome sequencing (see also Prenatal care and testing)
Prenatal testing information leaflet
R21 prenatal exome record of discussion / consent form
R21 prenatal exome Birmingham patient information leaflet
R21 prenatal exome local patient information leaflet
Exome/ genome information & consent (see also GENI section)
GENI patient information leaflet
GENI trio (both parents and child) consent form
GENI adult singleton consent form
Unique exome and genome sequencing information leaflet
Miscellaneous conditions (see also ‘Patients who are unlikely to benefit from a referral to Clinical Genetics)
GOSH Alpha 1 antitrypsin deficiency (A1ATD) patient information leaflet
A1ATD factsheet for primary care
ADAPT partial A1ATD (Pi MZ) information leaflet
Fetal Alcohol Spectrum Disorder (FASD) standard letter
Neural Tube Defects (NTD) patient information leaflet
Type 3 EDS/ Hypermobility spectrum disorder standard letter
Who to contact for general queries:
Clinical: genetic.medicine@belfasttrust.hscni.net / 028 9504 8022
Laboratory: GeneticsLabs@belfasttrust.hscni.net / 028 9504 7353