Thrombophilia Consent Form
Form Template
The Thrombophilia Consent Form
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app includes an informed consent and requisition for laboratory testing. Informed consent MUST be signed by patient, parent/legal guardian or legal next of kin. The app requests the following tests: Factor V Leiden (“R506Q”) mutation (HGVS designation: F5 c1601 G>A pArg534Gln) and Prothrombin “20210G>A” mutation (HGVS designation: “F2 AF478696.1 g21538G>A”). If you wanted your customer's name and the date to show up in your PDF filename, that is possible with GoCanvas.
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