MOLECULAR PROFILING (NGS) REQUEST FORM	CLONALITY STUDIES REQUEST FORM

Please note, the 'Molecular Profiling' request form above should only be used for BRAF or MGP-1 (22 gene panel) referrals. If you are considering sending a specimen for our larger MGP-2 (50 gene) panel, please call for additional information and a suitable request form.

Please Note: In order to receive results without undue delay, please ensure you fill out ALL sections of the request form in full. Also note, that if you require results to be faxed please include your fax number, and remember to tick the Fax Result box. We are unable to fax out patient results unless this box is ticked on your form."