How to Order

Contact RCIGM

1. If you have questions about the correct test to order for your patient at  RCIGM_rWGS@rchsd.org or (858) 966-8127.
2. Request a sample testing kit if this is the first time ordering or you do not have RCIGM sample testing kits on hand. Please allow at least 24 hours for receipt of the sample testing kit.

Consent & Sample Collection

1. Review the Requisition Form and the “About WGS” parent information sheet, available in the Clinician Toolbox.
2. Consent the patient/family for testing. If you have questions about informed consent, genetic counselors at RCIGM are available to speak with providers. Example Consent Forms.
3. Collect sample(s) following the sample collection requirements.
   • Label all samples with two patient identifiers (Name/DOB/MRN)
   • See requisition form for sample and labeling requirements.
   • Package each person’s specimen(s) in a separate biohazard bag

Requisition

1. Complete the Requisition Form. Existing partners use the
   online portalYou will need to authenticate via RCHSD's Microsoft 365 authentication system.
   Partner account required.
   Need help? (858) 966-8127
   . First-time clinical partners may download and print the requisition form here.
2. Send relevant clinical notes via one of four options:

• • Upload to
    RCIGM PortalYou will need to authenticate via RCHSD's Microsoft 365 authentication system. Partner account required.
    with case order (preferred).
  • Encrypted/secure email: RCIGM_rWGS@rchsd.org.
  • Include and send with packaged sample(s) and test requisition forms.
  • Fax to (858) 966-8092.

Package & Ship Samples

1. Package the sample(s) according to the specimen requirements instructions and include a copy of the requisition form.
2. Send sample via First Overnight delivery and follow the shipping instructions. NOTE: the RCIGM laboratory accepts samples Monday through Saturday until 3pm PST. View holiday schedule
3. After shipping, send tracking number to RCIGM_rWGS@rchsd.org and RCIGM_ClinicalLab@rchsd.org .

*RCIGM Clinical Services may only be ordered by a licensed clinician. We are unable to provide services directly to patient families.

Whole Blood (EDTA)

• Minimum requirement is one tube of ≥ 0.5 mL (cc) whole blood in an Ethylenediaminetetraacetic acid (EDTA) tube.
• Two tubes are strongly preferred to allow for identity confirmation check. One tube will be used for Whole Genome Sequencing and one for an orthogonal specimen identity check to ensure accuracy in sample collection and processing.

Extracted DNA

• DNA extracted from whole blood in a CLIA lab, collected in an EDTA tube may be sent instead of whole blood. Minimum DNA yield of 2 μg and a 20 ng/μL concentration is required.

DNA Isolation and Storage

• Minimum requirement is one tube of ≥ 0.5 mL (cc) peripheral blood in an Ethylenediaminetetraacetic acid (EDTA) tube.

Saliva

• Saliva may be sent for confirmatory testing only and must be collected using an Oragene DX OGD-500 collection kit. RCIGM is not validated to perform testing on saliva collected using other collection kits.
• Contact RCIGM Clinical Genome Center for additional ordering information and to request a kit.
• Donor must not eat, drink, smoke or chew gum for 30 minutes prior to collection. Collection instructions must be followed.

In the event the Clinical Genome Center does not receive sufficient sample material to complete the testing, the ordering party will be notified to provide an additional sample.

Please note: If hematological malignancy is suspected, we recommend using DNA extracted from cultured skin fibroblasts in a CLIA lab as source of germline DNA for germline genetic testing, particularly when testing for inherited predisposition to cancer, as DNA changes may represent somatic variation within the affected blood. Saliva and buccal swabs also contain peripheral blood-derived cells; therefore, DNA from these tissues should also not be used for investigating germline disease-causing variants in patients suspected to have a hematological malignancy.

Labeling Requirements

• Label sample tubes with at least two identifiers.
  • Preferred: patient’s full name and date of birth.
• We strongly recommend including the medical record number and/or specimen ID number also.

Shipping Conditions

• Do not freeze.
• Refrigerate until time of shipment at 2-8°C.
• Whole blood may refrigerated up to five days before shipping.
• Ship overnight delivery with a cold pack.
• Do not place cold pack in direct contact with sample.
• Shipping overnight at room temperature is acceptable if cold pack is not available.

Shipping Address

Rady Children’s Institute for Genomic Medicine
Attn: Clinical Genome Center
7910 Frost St, Suite 240
San Diego, CA 92123

• Mean time for returning provisional reports is under 3 days.

• Final results are typically delivered within 7 to 14 days for rWGS, or ≤ 30 days for standard WGS.
• Urgent, clinically actionable results will be communicated by phone, followed by electronic notification.
• If clarification of the test order or an additional specimen are needed, the ordering provider will be contacted. Please provide phone and email for communication.

Please provide the account and billing contact information in the Requisition Form, including:

• Institution
• Fed Tax ID
• Contact Name, Email
• Billing Address
• Phone, Fax

For fees, please attach written acceptance from the Ordering Provider’s authorized representative (e.g. email).

For Terms and Conditions, see the Requisition form for invoicing, billing, and payment.

Contact Us

For invoice and billing questions, email RCIGM_Accounting@rchsd.org
For test fee information, email RCIGM_rWGS@rchsd.org or call us at (858) 966-8127.