If you've landed on this page, either you -- and/or your Health Care Advocate who encouraged you to have your provider order the DNA test -- decided that it would be best for you to take the minimal effort route to have your provider order the DNA test.
If you don't mind a few extra steps and preparation, and if you don't mind advocating for yourself (and we'll tell you how to phrase it), you may increase the probability that your provider will cooperate with you.
If you want to explore that option before using the easy option below, go to this alternative explanation:
Otherwise, let's proceed with the easy route...
You may want to review these pages:
Now then, you are ready for...
In addition to the saliva swab test, your Health Care Advocate will provide the following paperwork:
Your Health Care Advocate can supply either or both of these forms... You can simply hand to your provider either of these one page forms you feel best does the job for you (pick just one):
or...
My Request for Pharmacogenomics Test (This is a "bulletized" form I created.)
This is in lieu of you advocating to the provider yourself that you want this test, and why.
(Or you can learn what to say in Option 2: YourTest.DNA.fyi)
There are instruction forms in the package, but the following are the ones which require provider signatures:
This consists of three pages (only two are signed by the provider).
(p.1) Test Request Form:
Complete the Patient Information and Insurance Information sections at the top.
That way, the provider doesn't have to ask you for the information, and it will also subtly inform the provider that you really want to have this test!
When the provider signs below, there is an additional line the name of the saliva test collector and date of collection. This date must match the date which is on the packet which will enclose the saliva test swabs.
(p.2) Genetic Testing and Billing Informed Consent:
Read, sign, print your name and date.
(Note: The provider will not need to sign that form so you won't even be handing that one to the provider.)
(p.3) Additional Information for Insurance Coverage:
I suggest studying the page and checking in light pencil in the margins (or Post It Notes) for the items you think apply to you so you can point those out to the provider. (Before your appointment, your health care advocate can possibly help you on this.)
You can ask the front desk person for this information...
Demographic Sheet. (This is a quick summary of your health conditions, etc.). Ask the front desk to provide a copy.
Front and back of your insurance card(s).
Your current medications.
This gives your provider access to the website portal which contains your DNA test, so have your provider complete and sign it.
Your Health Care Advocate has provided this extra form to you. Your Advocate will separately email this form before sending the test kit to the lab.
The reason it's not in the original packet is that a provider needs to only sign this once, then they don't need to sign it again for every subsequent patient. But most likely, you are the first patient!
Provide the paperwork with either of these pages on top (provided by your advocate):
...or
Before leaving the provider, determine whether the clinic personnel will be conducting the swab test and sending it to the lab, or whether you will have your Health Care Advocate do so. If clinic personnel are going to do this, refer to "If a Clinic Employee will complete these steps" below.
At this point, you're finished with the provider!
As mentioned above, either a qualified person in the clinic can collect your saliva samples and send the kit to the lab (skip further below), or your Personal Healthcare Advocate can do so (that's next, below). (Or of course your provider can collect the saliva sample.)
Pick one...
Ask the front desk for your demographic sheet with your current medications and insurance information before leaving the clinic.
Then your Advocate can perform the saliva sample and take care of the rest.
The collector needs to enter their name and date and clinic name on the bottom of the Test Request Form.
Hand the collector the Pharmacogenomics Test Ordering Instructions. Item #3 "Collect Sample" provides instructions.
There is an additional line at the bottom of p. 1 of the Test Request Form , to list the name of the saliva test collector and date of collection.
Emphasize that this date must match the date which is on the packet which will enclose the saliva test swabs.
Have them follow the instructions provided in the packet, to also include compiling the demographic sheet, insurance cards front and back, and your current medications.
During the week prior to your appointment on the following week, you or your Health Care Advocate can send the following website to the clinic and request that they forward it to your healthcare provider. (This will give the provider a chance to review the video over the weekend.)
In addition to the instruction forms for whomever is completing the saliva test for you and sending the packet to the lab, the following is a review of the forms discussed above:
(Your Health Care Advocate will email this separately, before the test kit package is sent to the lab.)
Demographic Sheet
Copy of Insurance Cards (front and back)
Optional, but this is your "advocacy letter" if you don't want to express it yourself. This is what you would give to the provider...
PGx Test Request Letter or My Request for Pharmacogenomics Test (pick one, not both)