Retinoblastoma Genetic Testing
- Download and complete the Impact Genetics Lab forms
- Order the test in Epic
- Draw the blood
- Send the Impact Genetics forms with the sample(s)
Impact Genetics Lab Forms
- Access the Impact Genetics Requisition Packet online .
- Print the Testing Requisition packet, Consent and the Sample Instructions.
- Partially prefilled forms here (updated April 3, 2022):Download
Epic Ordering
- Lab7505 RB1 Gene Analysis full sequence, bilateral, blood
- Lab7506 RB1 Gene Analysis full sequence, unilateral, blood
- Lab7507 RB1 Gene Analysis full sequence, tumor
- Lab3621 Miscellaneous Test (use for family members, known mutation) – free text in the comment section “whole blood to be shipped to Impact Genetics, Toronto, Canada for known familial mutation”.
- This will go to the lab and then UIHC Mail Out Service 6-8593