Forms and Requisitions


To order a genetic test, please complete the following forms with your patient:

  • Requisition form
  • Consent form
  • Payment form (if applicable)
  • Provincial healthcare funding application (if applicable)

Forms are reviewed and updated periodically. Review this page regularly to ensure you are using the latest versions.

If you have any questions about the tests or the ordering process, please do not hesitate to contact us.

Genetic Tests for Reproductive Health

Non-Invasive Prenatal Testing
Panorama™ Forms*


Panorama is now able to screen twin pregnancies, as well as pregnancies conceived using egg donors and surrogates!

Panorama™ is a Non-Invasive Prenatal Test (NIPT) that screens for common genetic conditions caused by extra or missing chromosomes in the baby’s DNA as early as 9 weeks. Panorama analyzes baby’s (placental) DNA through a simple blood draw from the mother’s arm.

Ordering Instructions

Mandatory Patient Consent Form 

Requisition Forms

Payment Form

 Requisition Change Form

Sample Reports

Genetic Tests for Cancer

Genetic Testing of 84 genes for Inherited Cancer Susceptibility

Our hereditary cancer panel offers a pan-cancer screening approach that includes full sequencing and copy number variant analyses of 84 of the more common genes associated with increased risk of developing hereditary breast, ovarian, uterine, colorectal, gastric, prostate, melanoma, and pancreatic cancer. Pre- and post-test genetic counselling is included.

Ordering Instructions

All Provinces

Mandatory Patient Consent Form

Patient Consent Form for BRCA1/2 English

Patient Consent Form for BRCA1/2 French

Requisition Forms

Hereditary Cancer+ Counselling Requisition Private Pay  English

Hereditary Cancer + Counselling Requisition Private Pay  French

Healthcare Professional Detail Aid 

BRCA1/2 Physician Resource

Hereditary Cancer Risks and References


Contact Us

Genetic testing can seem complicated. Our team of certified genetic counsellors and client-care specialists are available to support you along the way.

To ensure we provide you with the correct information, please select your province.

To ensure we provide you with the correct information, please select your province.
  • British Columbia
  • Ontario
  • Alberta
  • Manitoba
  • New Brunswick
  • Newfoundland and Labrador
  • Northwest Territories
  • Nova Scotia
  • Nunavut
  • Prince Edward Island
  • Quebec
  • Saskatchewan
  • Yukon