Fragile X Consent Form
Form Template
The Fragile X Consent Form mobile app includes an informed consent and requisition for laboratory testing.
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Informed consent MUST be signed by patient, parent/legal guardian or legal next of kin. The app requests the following tests: Southern Blotting for FMR1 5’UTR CGG Repeat Expansion (“Fragile X Test”). By turning on HIPAA compliance, a number of features that most of users find desirable will be disabled to meet the requirements dictated by HIPAA.
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