Informed Consent Form for Genetic Testing
Personal Information
Full Name
Date of Birth
Patient ID / Reference Number
Purpose of Genetic Testing
Information Provided
I have been informed about the purpose, procedure, benefits, and possible risks of genetic testing.
I understand the potential implications of test results for myself and my family members.
Confidentiality and Data Privacy
I understand how my genetic information will be protected and used.
Consent and Authorization
I consent to undergo genetic testing.
I authorize sharing of test results with my healthcare provider.
Additional Notes / Conditions
Signature
Signature
Date