Referrals and Appointments for Cancer Genetic Risk Assessment
Appointments: 415-600-3073
Questions: 415-600-5961
Office Fax: 415-600-1565
In order to maximize your appointment, you will be asked to complete the Medical History questionnaire [PDF 40 kb] and the Family History questionnaire.
(Download a free copy of Adobe Acrobat Reader)
Please complete the forma to the best of your ability. Feel free to add additional information/comments at the back of the form. If you have questions or need help in viewing or filling in the forms, please call 415-600-5961, and we will be happy to assist you.
Please fax back to 415-600-5975, or mail to:
Cancer Genetic Risk Assessment Program,
California Pacific Medical Center – Pacific Campus,
2351 Clay St., #134
San Francisco, CA 94115
If a medical professional is referring you to our program, they will need to print and complete our referral form (PDF, 55KB) and mail or fax it to us with a copy of you most recent consult notes.
Insurance authorization is required for a genetic counseling appointment. But it is not necessary to obtain authorization for genetic testing prior to your appointment. If you require assistance or more information, please contact us at 415-600-5931.