Non-Invasive Prenatal Testing 
TreatGxPlus 
Genetic Testing For Breast Cancer 
Whole Exome Sequencing 
Single Genes + Panel Testing 
Search for a Test 
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*
Update:
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 |
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Mandatory Patient Consent Form (Kept in Patient File) | |
Requisition Forms | |
Payment Form | |
Requisition Change Form | |
Sample Reports |
*Forms last updated in August 2017
Genetic Carrier Screening
Counsyl Forms*
The Counsyl Foresight Screen identifies parents-to-be that are likely to pass on genetic conditions to their children. Even without a family history of disease, you can still be a carrier and benefit from this test, which screens for over 175 conditions before or during pregnancy. Please note that this is NOT a prenatal screen and does not test baby’s DNA (i.e., placental or fetal DNA).
Private-Pay Payment Form for Counsyl
Ordering Instructions | |
Mandatory Patient Consent Form | |
Private-Pay Requisition Forms | |
Payment Form |
Healthcare Professional Detail Aid |
*Forms last updated in August 2017
Genetic Tests for Cancer
Hereditary Breast and Ovarian Cancer (HBOC) Susceptibility Testing
BRCA1 + BRCA2 (with Genetic Counselling) Forms*
This test identifies women and men who are at an increased risk for developing certain cancers (e.g., such as breast, ovarian, fallopian tube, peritoneal, melanoma, pancreatic, and/or prostate cancer).
Ordering Instructions | |
Mandatory Patient Consent Form | |
Requisition Forms | BRCA1/2 + Counselling Requisition Private Pay English |
Healthcare Professional Detail Aid | BRCA1/2 Physician Resource |
*Forms last updated in August 2017
Whole Genome Sequencing (WGS)
CentoGenome® Forms
WGS is one of the latest genetic technologies that sequences the entire coding and non-coding regions of the genome to help provide answers for individuals with complex disease where other tests have not.
Ordering Instructions | |
Requisition and Patient Consent Form | Please contact us to discuss your WGS needs and get the forms |
*Forms last updated in August 2017
Genetic Tests for Hereditary Conditions
(Forms for 3500+ Genetic Tests)*
These 3500+ diagnostic and predictive single gene and genetic panel tests provide concrete, actionable insights that lead to informed decision making and personalized treatment.
Search for a test using our Search tool to access a full range of diagnostic, predictive, carrier, and prenatal genetic tests completed at our lab in Toronto or by our partner CENTOGENE
Please use the search tool to identify the test code and name on page 2 of the requisition.
Ordering Instructions |
|
Requisition and Patient Consent Form | |
Application for Ministry Funding |
*Forms last updated in August 2017
Pharmacogenetics
TreatGx Plus Testing Service
TreatGx Plus suggests safe effective medication options by looking at medication-to-medication, medication-to-disease, and medication-to-genetic interactions. These results lead to personalized medication and dosage options. The service spans hundreds of medications and dozens of common conditions.
This test requires a requisition form for patients which can be downloaded here.
To register for the software, please click here. Each order includes a home collection kit delivered directly to your patient and a subscription to the medication decision-support software.
How to Change a Requisition
Changing Genetic Testing Instructions
At LifeLabs Genetics, we are keen to provide useful, accurate, and reliable results. If your patient’s details change and you’d like to update a requisition that you’ve already submitted, contact us. We may be able to adjust the test to meet your new requirements within the usual turnaround time or send you an altered report.
Changing a Panorama® Requisition
The Panorama® non-invasive prenatal test has a specific change authorization form. If the due date changes or the parents would now like to know the baby’s gender, for example, please complete and submit this form to speed up the change process.
