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Genetic Testing
DIAGNOSTICS
Whole Exome Sequencing
Whole Genome Sequencing
Panel
• Genetic counseling
RESEARCH
Newborn Screening
WITH THE GENETICIST
Paternity Testing
ART Genetic Pathway
PREDICTIVE
EXOME PRO / GENOME PRO
Clinical Insights
VUS. Open Diagnosis
A Diagnosis As a History
The Symptom You Didn’t Mention
The Re-Reading of a Life
The Human Signature
FROM PRACTICE
The Eighteenth Case.
Vault
Applications
Fetal Exome After Pregnancy Loss
From Within The Hospital Itself
International Referrals
Industrial Genomics
Laboratory Services
Sequencing-only
Ultrafast Workflows
Newborn Screening
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/ TELEMEDICINE – BOOKING
TELEMEDICINE – BOOKING
TELEMEDICINE – REQUEST FORM
Title
*
Mrs
Mr
Name
*
Surname
*
Email Address
*
You’ll receive the videocall link to this email address.
Phone number
Home Address
*
A home address is required for invoicing. Please give street name, town, ZIP code, and country of residence.
Clinical information
*
Please give here a brief summary of the clinical case, so to help us preparing for the counselling.
Date
Time
Please select an option (Italian, Rome time)
11:00
17:00
18:00
Discount Code
If you have any discount code, please type it in this field (all capital letters).
Privacy
*
In accordance with European GDPR (Regulation on data privacy protection), I hereby declare to have read the
privacy protection protocol
and I authorize you to process my personal data for the purposes of this counseling service.
By clicking Submit below you’ll be redirected to the payment page (PayPal). Once the payment is completed, you will receive a confirmation email containing the Skype connection details.
If you are human, leave this field blank.
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