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  • Thank you for contacting HD Genetics. This is our client intake questionnaire for individuals interested in learning more about HD Genetics’ Genetic Counseling and Testing Service. This survey is intended to help the HD Genetics team learn more about you. We appreciate you providing complete and thorough answers which will help us provide you with a high-quality experience.

    All of the information you provide is securely stored using HIPAA-compliant software technology. Unless we have your permission or are mandated for legal reasons, all personal identifying data will not be shared outside of the HD Genetics team and laboratory partner.

    Within two business days after completing this questionnaire, the HD Genetics team (Wes Solem, licensed genetic counselor) will contact you to confirm your interest in genetic counseling and schedule your first session with HD Genetics’ licensed counselor, which is provided at no-cost.

    This questionnaire should take you ~10-15 minutes to complete. If you aren’t able or willing to complete all the questions, please submit it with your contact information and the HD Genetics team will contact you to obtain any missing information.

    Thank you for considering HD Genetics to provide you with more information about the option of presymptomatic testing for Huntington disease.

  • General Information

  • Family History

  • HD Predictive Testing

  • Medical History

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  • HD Genetics Operations

  • Support Person

    We highly encourage you to have a support person join you throughout your genetic testing process. This can be anyone (up to two people) you feel would be the most supportive of you during this time. We recommend that your support person is someone who is not also at risk of HD, so that the process fully focuses on you and your needs, and that you are able to express yourself freely without having to consider others’ feelings in the moment. If you’d like more than two support people, please let us know during our follow up call. You are not required to have a support person with you throughout the process.
  • General HD Info

  • The details of your telehealth interaction, which may include oral, visual, and electronic communications between you and your HD Genetics provider, will NOT become part of your medical records.

    Under certain circumstances, telehealth may not be as appropriate as face-to-face interaction, and your HD Genetics genetic provider may refer you to a local Huntington’s disease specialist for follow-up or additional care.

    In some cases a genetic counseling student/trainee (“Trainee”) may participate in your telehealth appointments. You will be informed if a Trainee is participating in your appointment. Trainees will be supervised by your Provider, and your Provider will be present during your entire consultation. However, you may request at any time that the Trainee not participate in your consultation.

    The Information provided by HD Genetics is not intended to replace the medical advice and recommendations of your existing healthcare team. If you have non-genetic concerns about a current health condition, you should consult your local healthcare provider.

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