GLEX Portal: Electronic Request Forms and Results

Request forms and informed consents for download

Others: Informed consents etc.

K-Request form for examination, general (CZ)
Informed Consent to Carry out Preimplantation Genetic Testing (PGT) (EN)
Informed consent to the execution of PGT (CZ)
Informed consent for examination (CZ)
Informiertes Einverständnis für die Durchführung der PGT (DE)
Informed consent to genetic tests (PRENASCAN) (CZ)
Consenso informato all'esecuzione dell´esame della diagnosi genetica del preimpianto (PGT) (IT)

Preconception genetic testing

Request form: Genetic examination - PKP, gamete donation (CZ)
Request form: genetic examination - PKP, gamete donation (CarrierTest) (CZ)
Request form: CarrierTest (EN)
Request form: Predictive genetic testing - CarrierTest panel (CZ)
Request form: Endometrium Receptivity Test (CZ)

Preimplantation genetic testing (PGT)

Request form: Preimplantation Genetic Examination (CZ)
Request form: PGT-M preparation – patient (EN)
Request form: Preparation for pre-implantation genetic examination (PGT) - female patient (CZ)
Request form: PGT-M preparation – partner, relatives (EN)
Request form: Preparation for pre-implantation genetic testing (PGT) - relative, partner (CZ)

Non-invasive Prenatal Genetic Testing

Request form: Non-Invasive Prenatal Test of aneuploidy from cfDNA (CZ)
Request form: PRENASCAN (EN)
Request form: PRENASCAN (CZ)
Informed consent for PRENASCAN (EN)

Genetic testing prenatal - invasive and postnatal

Request for molecular genetic examination (EN)
Request form: Molecular genetic examination (CZ)
Request form: Thrombophilic mutations (CZ)
Request for laboratory examination - Oncogenetic panel CZECANCA (EN)
Request form: Hereditary Oncogenetic CZECANCA panel (CZ)
Request form: Immunogenetic examination (CZ)
Request form: Clinical EXOME - Proband (EN)
Request form: Clinical EXOME - proband (CZ)
Request for genetic examination - Clinical EXOME - Blood relatives of the proband (EN)
Request form: Clinical EXOM - Blood related proband (CZ)
Request form: Deafness examination & Neuro-genetic diseases (CZ)
Request form: Relatedness genetic examination of persons (CZ)
Request form: Cytogenetic/Molecular genetic examination (EN)
Request form: Cytogenetic/Molecular genetic examination (CZ)
Indications for SNP array prenatal examination (CZ)
Indications for SNP array examination - patient clinical data (CZ)