Required Documents
For your facility, please find a list of the test request forms, patient consent and consultation forms and clinical information forms which are required for certain tests performed at Eurofins Biomnis. You can also download these forms directly from our online test guide.
Genetics
Prenatal Constitutional Genetics
B3-INTGB – Antenatal diagnostics request form
Download
D44-INTGB – Information and consent for pregnant women / Information and consent prior to the carrying out of genetic examinations of an individual
Download
Postnatal Constitutional Genetics
B12-INTGB – Constitutional molecular genetics request form
Download
B34-INTGB – Exome request form
Download
R23-INTGB – Cystic fibrosis gene analysis (CFTR gene)
Download
D44-INTGB – Information and consent for pregnant women / Information and consent prior to the carrying out of genetic examinations of an individual
Download
R36-INTGB – Familial Mediterranean Fever gene study
Download
B61-INTGB – Cardiogenetics request form
Download
Pharmacogenetics
K23-24B-INTGB – Evaluation of the toxicity risk of fluoropyrimidines and determination of 5-fluorouracil
Download
D23-INTGB – Declaration of consultation and consent
Download
Constitutional cytogenetics
Pre and Postnatal constitutional cytogenetics
B13-INTGB – Cytogenetics request form
Download
D43-INTGB – Declaration of medical consultation and patient consent form for genetic testing.
Download
Oncology-Haematology
Acquired cytogenetics
B8-INTGB – Malignant Blood Disorders request form.
Download
B9-INTGB – Oncology-Solid tumors request form.
Download
Somatic genetics
B8-INTGB – Malignant Blood Disorders request form.
Download
B9-INTGB – Oncology-Solid tumors request form.
Download
B25-INTGB – Genetic signature test for breast prognosis cancer.
Download
Cellular haematology
B8-INTGB – Malignant Blood Disorders request form.
Download
T21 screening, Pre-Eclampsia and Fœtal Biochemistry
T21 Serum Markers
B2-INTGB – Estimated risk of foetal trisomy 21 request form
Download
NIPT (Non-Invasive Prenatal Testing) Test
B17-INTGB – NIPT Test Request Form
Download
D17-INTGB – NIPT Test Information and Consent Form
Download
Fœtal Biochemistry and Pre-Eclampsia screening
R4-INTGB – Estimated risk of pre-eclampsia through the evaluation of maternal serum markers during the 1st trimester of pregnancy
Download
Infectiology
Covid-19
B3-INTGB – Test request form: Antenatal diagnostics on invasive sampling
Download
R55-INTGB – PCR Covid-19 (SARS-CoV-2)
Download
D44-INTGB – Information and consent for pregnant women / Information and consent prior to the carrying out of genetic examinations of an individual
Download