To refer a patient for evaluation:

  • Please enter an ambulatory referral to Adult and Cancer Genetics in Epic.
  • Please include the reason for the evaluation in the “comments” section. Your patient will be contacted to schedule an appointment.
  • If your patient has relevant medical records that are not in Epic, please fax a copy of these records to 919-966-4151.
To refer a patient for evaluation:

  • Please complete this form and fax it to 919-966-4151.
  • Your patient will be contacted to schedule an appointment.

If your patient has been diagnosed or treated outside of the UNC system:

  • Please provide us with relevant clinic notes and test reports.
  • Please also provide us with a copy of any previous genetic test results.
Your patient will be best served if we are able to review their relevant medical records prior to their appointment. In general, the following records are helpful, if available:

For connective tissue disorders (such as Marfan syndrome or Ehlers-Danlos syndrome)

  • Rheumatology clinic notes
  • Echocardiogram report
  • Ophthalmology clinic notes
  • Relevant medical records for relatives with the same condition or symptoms (for example, clinic notes documenting a diagnosis in a relative, genetic test report for a relative, etc.)

For hereditary neurological conditions and neuromuscular diseases (such as Huntington disease, ataxia, Alzheimer disease, Duchenne muscular dystrophy, or hereditary neuropathy)

  • Neurology clinic notes
  • Neuroimaging reports
  • Electrophysiology study results (EMG, NCV)
  • Relevant medical records for relatives with the same condition or symptoms (for example, neurology notes documenting a diagnosis in a relative; an autopsy report confirming Alzheimer disease in a relative; genetic test report for a relative; etc.)

For suspected mitochondrial disorders and/or metabolic disorders

  • Relevant biochemical/metabolic test results (for example, acylcarnitine profile, organic acid levels, amino acid levels, etc.)
  • Neurology clinic notes and results of related testing or imaging
  • Clinic notes from previous genetic evaluations (including any test results)
  • Relevant medical records for relatives with the same condition or symptoms (for example, clinic notes documenting a diagnosis in a relative, genetic test report for a relative, etc.)

For intellectual disability and/or autism syndromes (such as Fragile X syndrome)

  • Neuropsychology notes
  • Clinic notes from previous genetic evaluations (including any test results)
  • Relevant medical records for relatives with the same condition or symptoms (for example, clinic notes documenting a diagnosis in a relative, genetic test report for a relative, etc.)

For conditions involving dysmorphic features or congenital anomalies (birth defects)

  • Clinic notes and/or imaging reports documenting features
  • Neuropsychology notes
  • Clinic notes from previous genetic evaluations (including any test results)
  • Relevant medical records for relatives with the same condition or symptoms (for example, clinic notes documenting a diagnosis in a relative, genetic test report for a relative, etc.)

For inherited cardiac conditions (such as long QT syndrome or cardiomyopathy)

  • Cardiology clinic notes
  • Relevant cardiology results (for example, ECG results, echocardiogram results, etc.)
  • Relevant medical records for relatives with the same condition or symptoms (for example, clinic notes documenting a diagnosis in a relative, genetic test report for a relative, etc.)

If you have specific questions about which records may be relevant for your patient:

  • please call LaTonya Williams at 919-843-8724 and ask to speak to the genetic counselor on call.