Genformatic Order Form
Please submit a response, and we will email you a follow up with more information
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What is your name? *
What is your email address? *
What is your affiliation (e.g. university, healthcare system, company, or individual)
What do you want to order? *
Check all that apply.  For instance, if you want to know what mutations are present in a malignant tissue sample, then order tumor/normal tissue sequencing.  If you also want help interpreting what your (or your patient's) somatic sequencing results mean, and be educated about how those results may affect your (or your patient's) prognosis or treatment options, and get a list of potentially relevant clinical trials of new drugs, then choose tumor/normal sequencing and genome interpretation. If you also want a concise report of the most clinically relevant results to share with your doctor, and an opportunity to consult with a genomics expert or counselor then choose, Somatic Sequencing, Genome Interpretation and Genomic Health Report
Why do you want sequencing and/or analysis? *
How many samples do you have?
What kind of data do you have or want?
If you want whole genome sequencing, indicate "whole genome".  If you want to find out what somatic mutations exist in a tumor, then choose "Tumor and Normal Tissue Exome data"
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What depth of sequence coverage do you want, or have ready for analysis? Describe average genomic coverage or provide another data metric. If you want to follow our recommendation, based upon your needs or what you want to know or the testing you have ordered, then indicate "Your recommendation"
How deeply do you want to search for answers?
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What is your phone number *
We will contact you by telephone to obtain verbal confirmation of your order, and payment information
Who is your healthcare provider, and how should we contact them. *
Sometimes, a physician's order is necessary efore we can do testing or reporting.  In those circumstances we need to be able to submit a requisition form to your healthcare provider for their signature.  Mailing address or email address is essential, and you may want to contact your provider to alert them to act on our request for a formal test requisition.
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