We use a Google Analytics cookie to gather anonymous information about how our site is used.
If you continue using our site we'll assume that you are happy for the use of this cookie to continue.
Speak to one of our gene health advisors: 0800 331 7177 or

Recommended Referral Criteria & Form

Recommended referral criteria

Any women concerned about her family history should be referred for a comprehensive risk assessment, and screening recommendations; particularly those diagnosed under the age of 40

Clients with a personal history of breast cancer AND one of the following meet criteria for genetic testing:

  • Jewish Ancestry
  • Diagnosed < 40 years
  • Diagnosed < 60 years AND triple negative
  • Ovarian cancer diagnosis
  • Bilateral breast cancer
  • Male breast cancer
  • Significant family history:

- 2+ relatives diagnosed with breast cancer

- Relative with ovarian cancer

- Relative with male breast cancer

  • Unaffected women with a FDR meeting the above criteria

If your patient has Private Medical Insurance please click here to assess if your patient is likely to be covered.

Referral to (if known):
Clients's Details
Clients's titles*
Clients's first name *
Clients's last name *
Clients's email *
Clients's postcode *
Clients's address 1*
Clients's address 2
Clients's city *
Clients's date of birth
Clients's telephone *
Reason for referral *
Consultant Details
Your name + title
Your telephone
Your email
Please un-tick the box if you do not want
our newsletter
Verify you're not a robot. What is 4 + 3 *
* Mandatory field
Genetic Counselling Services
If you have a family history of cancer
Complete a referral
Refer a patient or yourself
© 2017 GeneHealth UK, 1 The Mill, Copley Hill Business Park, Cambridge Road, Cambridge CB22 3GN - Registered in England and Wales. Company registration number 08866941
All data send on this website is encrypted (SSL).