Lifera OmicsClinical Genomics Laboratory

Genomic Data Reanalysis Request

Access is restricted to registered requesting physicians and laboratory staff. If you do not have an account, contact the laboratory to be registered.

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Lifera OmicsClinical Genomics Laboratory

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Open your authenticator app and enter the 6-digit code for your account.

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Lifera OmicsClinical Genomics Laboratory
Form no.
LO-F-GR-01
Revision
1.1
Reference SOP
Genomic Data Reanalysis v1.1

Genomic Data Reanalysis Request Form

Sections 1–6 are completed by the requesting physician. Sections 7–8 are completed by the laboratory on receipt.

All fields marked with * are mandatory. A separate form is required for each index patient. Please attach the signed consent form.
* Mandatory
Confidential — patient identifiable information