Documents and Forms

Tests that are performed by specialist labs in the SE GLH region have separate forms that can be downloaded from this page and completed electronically. 

Please note that hand written forms for Whole Genome Sequencing will no longer be accepted. We’ve made this change to speed up the process.

Please refer to the corresponding linked specialty pages for eligibility, sample requirements and further information

Non-Cancer test request forms:

Cancer test request forms:


All genetic testing requires consent. It is the responsibility of the referring clinician to obtain appropriate consent from the patient for genetic testing. This should be saved in local patient records and does not need to be sent with the request form.

Non-WGS Record of Discussion

WGS Record of Discussion

Translated WGS RoDs and patient information sheets can be found here.

Confirmation testing Record of Discussion

Please use this Record of Discussion if you are:

    • confirming an identified somatic variant
    • doing predictive testing for known familial variants

Coming soon

We are still working on this page of the website and will launch soon. 

In the meantime, if you would like to request a Dermatology test please use the SE GLH Dermatology Request Form v.1.1.  

Please get in touch if you have any questions.

Information for clinicians:

To improve the diagnostic potential of Whole Genome Sequencing, we are introducing the following change:

Carrying out Whole Genome Sequencing as a trio with the parents of the affected child increases diagnostic rate and accuracy, reduces the chance of an inconclusive result and reduces the turnaround time. As a result, singleton referrals where the proband is under 16 will now be put on pause until Records of Discussion and samples are obtained from parents. The exception to this is R193 Cystic Kidney Disease, or cases where a coroner is involved.

If it is not possible to obtain a sample and ROD from the parents, please do let us know and the referral can be processed as a duo (if only one parent sample can be obtained) / singleton.  Please note that parents do not need to be affected, as testing unaffected parents may still increase the diagnostic rate and accuracy for the affected child. 

Please note, completing the referral form electronically would reduce discrepancies and any delays in testing

With any Whole Genome Sequencing (WGS) test ordered, a Record of Discussion (RoD) form will also need to be submitted. This document is to record the patient’s consent for genomic testing and their choice on taking part in research. Guidance on the patient choice conversation can be found here
This RoD form will be available for clinicians to download from this webpage. Once completed with the patient, it can be send to the lab with the corresponding test order form and sample.
Tests available to order will be listed in the National Genomic Test Directory. A test order form will soon be made available for clinicians on this webpage to download and complete. This form will include the address of the laboratory that the appropriate sample and completed form needs to be sent to.
Until the new Genomic Laboratory Service goes live, please continue to follow existing test order processes.
Later this year, the online test ordering tool for Whole Genome Sequencing will be integrated into the National Genomics Informatics System (NGIS) and clinicians will be able to search or filter to find a clinical indication, confirm eligibility criteria and start the test request process for their patient.