Clinical Questionnaire for Prenatal SNP Microarray

This form should be completed when SNP-based chromosome microarray testing is ordered (tests 510100, 510110, 510160, 052090, and 052190). The form should be completed by the ordering physician's office and should accompany the specimen. Please call 800-345-4363 with any questions and ask to speak to a cytogenetics genetic counselor.

For Providers

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