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Personalized Prescribing

Referral Form

Healthcare professionals can refer patients for pharmacogenomic testing using our referral form.

Need to fill out the referral by hand or keep a copy for your records? You can download the PDF version from our resources page.

How to Refer a Patient

Please visit our dedicated referral form page to submit a referral electronically, or contact us at info@personalizedprescribing.com for assistance.

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