How to Submit a Pediatric/Adult Sample
- Refer to Sample Requirements page
- Print and complete patient information and referring physician information on Signature Patient Requisition form. Please obtain parent/guardian signature.
(New York clients, please print and complete the Consent for Molecular Testing.) - Indicate payment method.
Please refer to Parental Testing Policy for details on billing for parental samples.
- For Institutional Billing, print and complete:
- For Patient Insurance/Self Pay please have patient read and sign:
- Indicate analysis requested:
- SignatureChip® WG or OS
- See comparison page for details.
- SignatureFISH
- Indicate single/dual FISH. Please call for available loci.
- Karyotype
- Can be combined with any service.
- Parental Study
- Provide name and SGL# of child.
- Provide indication for study, including ICD-9 codes.
- Indicate sample type.
- Ship sample with completed forms overnight at ambient temperatures to:
Signature Genomic Laboratories
2820 N. Astor Street
Spokane, WA 99207 - Email Signature Genomic Laboratories the Courier Tracking Number of the parcel.
Results will be faxed and mailed according to the details given on the Signature Genomics Patient Requisition Form. In the event of abnormal results, the referring clinician will also be contacted by telephone. For questions, please call (509) 474-6840.