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Genomics / Molecular biology / Medical genetics / Human genetics / Exome sequencing / Full genome sequencing / Genetic testing / Genetic counseling / American College of Medical Genetics / Biology / Medicine / Genetics


Exome Requisition Form The University of Chicago Genetic Services Laboratories 5841 South Maryland Avenue, Room G701/MC0077, Chicago, IL[removed]Toll Free: [removed] | Local: [removed] | Fax: [removed]ucgslabs@ge
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Document Date: 2014-07-23 14:30:07


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City

Chicago / /

Company

The Northern Trust Bank / Services Laboratories / The University of Chicago Genetic Services Laboratories / /

Country

United States / Canada / /

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Event

FDA Phase / Funding / /

Facility

University of Chicago Medical Center RECOMMENDED BUT OPTIONAL CONSENT/AUTHORIZATION BY SUBJECT FOR PARTICIPATION / University of Chicago The Division / University of Chicago Medical Center REQUIRED Carrier Status / American College of Medical Genetics / University of Chicago Medical Center REQUIRED Patient Name / University of Chicago / University of Chicago Wire Account No. / The University of Chicago / McGiffert Hall / Exome Requisition Form The University of Chicago Genetic Services Laboratories / The American College of Medical Genetics / /

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IndustryTerm

report carrier status / carrier parents / credit card processing / Insurance prior authorization / insurance / direct insurance billing / insurance company resulting / Insurance prior authorization services / carrier status / imaging / bank fees / diagnostic applications / carrier test / /

MedicalCondition

recessive disorder / Microcephaly / Mendelian disorders / Fanconi Anemia / NO UNKNOWN Cleft lip / significant human disease / Familial Dysautonomia / Tay Sachs disease / NO UNKNOWN Autism spectrum disorder Behavioral / Psychiatric / contracture / disorder / Cystic Fibrosis / Hearing impairment / Alzheimer’s Disease / Hb Beta Chain Related Hemoglobinopathy / genetic disease / same human disease / disease / common disorders / genetic diseases / Bloom syndrome / Canavan disease / Gaucher disease / NO UNKNOWN Cognitive impairment / diseases / Sickle Cell Disease / Beta Thalassemia / high blood pressure / Mucolipidosis IV / human disease / disorders / /

MedicalTreatment

counseling / /

Organization

University of Chicago Medical Center REQUIRED Carrier Status of Recessive Disorders / Institutional Review Board / University of Chicago Wire Account / UNKNOWN Seizures Movement / University of Chicago Medical Center REQUIRED Patient Name / University of Chicago Medical Center RECOMMENDED BUT OPTIONAL / The University of Chicago / University of Chicago / Referring Lab / The American College / Division of Biological Sciences / Billing Institution / /

Person

Soma Das / Ordering Physician / /

/

Position

Hb / Physician Information REPORTING RESULTS / Physician / Representative / genetic counselor / /

Product

Soma / BETTER UNDERSTANDING OF / /

ProvinceOrState

Illinois / /

PublishedMedium

Guardian / /

Region

South Maryland / /

Technology

Genomics / drug metabolism / human genome / MRI / /

SocialTag