genetworx.com
Open in
urlscan Pro
34.75.179.1
Public Scan
Submitted URL: https://e.genetworxlaboratory.com/MzEwLVlVTy0xNzYAAAGFRQcNQ30mEp0zF8kAQHbAs2k46mgULssNliO3ZliNdPklycuvZORiKgjEoFzpT8Z3bF9gGZM=
Effective URL: https://genetworx.com/services/pharmacogenomic-testing/?mkt_tok=MzEwLVlVTy0xNzYAAAGFRQcNQ4VUfdKa7_HVUrN2Y_caFELJtZjyyE...
Submission: On June 27 via api from US — Scanned from DE
Effective URL: https://genetworx.com/services/pharmacogenomic-testing/?mkt_tok=MzEwLVlVTy0xNzYAAAGFRQcNQ4VUfdKa7_HVUrN2Y_caFELJtZjyyE...
Submission: On June 27 via api from US — Scanned from DE
Form analysis 8 forms found in the DOM
GET https://genetworx.com
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<div class="elementor-search-form__container">
<input placeholder="Search GENETWORx" class="elementor-search-form__input" type="search" name="s" title="Search" value="">
<button class="elementor-search-form__submit" type="submit" title="Search" aria-label="Search">
<i aria-hidden="true" class="fas fa-search"></i> <span class="elementor-screen-only">Search</span>
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</div>
</form>GET https://genetworx.com
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<div class="_updated_consent">
<p>Your privacy is important to us. By clicking Submit, you confirm that you have reviewed our privacy policy and agree to our terms of use and that your information may be shared with RCA and affiliated companies, who may contact you to
keep you updated with important health-related information.</p>
<p>By entering your mobile number and clicking Submit, you also consent that RCA and affiliated companies may send you SMS messages using autodialing technology from our primary messaging code 73529 for health-related information and as
described in our terms of use in our privacy policy. Std. msg & data rates apply. Reply HELP or help, STOP to cancel. Msg freq may vary. Your consent is not required as a condition of purchasing any product, good, or service.</p>
<h5>Informed Consent to Participate in Medical Record Registry</h5>
<p>GENETWORx and its affiliates (“We, Us, Our”) are creating a medical record registry to help Us predict, prevent, and treat disease (the “Registry”). The Registry matches patients’ laboratory test information with medical history
information obtained from health plans, physicians, health care professionals, hospitals, clinics, laboratories, pharmacies, pharmacy benefits managers, and other medical facilities. We will use data analytics, artificial intelligence
and other automated tools to analyze the data in the Registry for various purposes including improving Our patient care and outcomes, lowering costs, recommending products and services to support your health and wellbeing, or sharing
data with other healthcare providers, medical researchers, drug developers, and clinical trial teams to advance medical science.</p>
<h6>SUMMARY OF INFORMATION</h6>
<ul>
<li>This Informed Consent and Authorization asks for your permission to participate in the Registry by allowing Us to obtain, store, use and share your information.</li>
<li>Participation is voluntary and will not affect your care in any way.</li>
<li>We may share your de-identified information with third parties without any further consent or authorization.</li>
<li>Once collected by Us, your information will be stored with industry standard security safeguards.</li>
</ul>
<h6>WHAT IS A REGISTRY?</h6>
<p>A Registry is a collection of information about people who have various diseases or conditions, or who receive various tests or treatments. The Registry holds patient information according to the data security standards of federal and
state law.</p>
<p>This Informed Consent provides you with information that you should know and understand before agreeing to add your information to the Registry. Please read this Informed Consent carefully.</p>
<h6>WHAT INFORMATION IS BEING COLLECTED FOR THE REGISTRY?</h6>
<p>Information (data) will be collected from your health plans, physicians, health care professionals, hospitals, clinics, laboratories, pharmacies, pharmacy benefits managers, and other medical facilities. We will collect health,
demographic, claims, billing, pharmacy and medical records. All information will be collected from your records of the care you have received in the past ten years, are receiving or will be receiving in the future for so long as you
continue to participate in the Registry.</p>
<h6>HOW WILL INFORMATION IN THE REGISTRY BE USED?</h6>
<p>The purpose of this Registry is to help Us predict, prevent, and treat disease. Information in the Registry may be used for medical, research, commercial, marketing or other business purposes including, but not limited to providing
healthcare or care coordination services, communicating with you about diagnostic tests, clinical trials or other healthcare related services that may be of interest based upon your medical history including marketing and promoting our
services and the services of third parties, aggregating and analyzing data to understand or improve Our testing, treatment services, and operations, research to predict, prevent and treat disease(s), de-identifying data to create data
sets that will be shared with third parties such as medical researchers and drug developers to advance medical treatment, for administrative purposes, and for other legally permissible purposes.</p>
<h6>HOW WILL MY HEALTH INFORMATION BE SHARED?</h6>
<p>We may share your identifiable information with Our affiliates under common ownership to use for the same purposes for which We may use your information. We may also share your information with third party service providers performing
services on our behalf. We may share your information for legal purposes including as we deem necessary to respond to a subpoena, regulation, binding order of a data protection agency, legal process, governmental request or other legal
or regulatory process. We may also share your information in business transfers including in connection with a merger, acquisition, the sale of company assets, or in any similar transaction, or to the extent as may be required in the
unlikely event of insolvency bankruptcy, or a receivership. Once your information is de-identified is no longer personal information and can be used by Us and shared with third parties for any purposes, including sale to third parties.
</p>
<h6>HOW LONG IS YOUR PARTICIPATION IN THE REGISTRY?</h6>
<p>With your authorization, we will collect your historic and future health information when you enroll in the Registry. You may stop participating in the Registry at any time.</p>
<h6>WHAT RISKS ARE KNOWN ABOUT BEING IN THE REGISTRY?</h6>
<p>We will comply with the applicable HIPAA standards that protect your health and personal information. However, there is the potential risk your participation in this Registry may expose your information (including health information)
stored in the Registry. <br> There may be other risks that are not known at this time.</p>
<h6>WHAT BENEFIT CAN YOU EXPECT?</h6>
<p>You may receive a benefit from participation in the Registry if We are able to provide you information about diagnostic tests or clinical studies for which you may be eligible. For research related purposes, you will not receive any
direct benefit.</p>
<h6>WHAT ARE THE FINANCIAL CONSIDERATIONS?</h6>
<p><strong>Cost</strong> <br> There will be no cost to you for your participation in this Registry. <br> <strong>Payment for Participation</strong><br> You will not be paid for your participation in this Registry or for any future use of
the information in the Registry.</p>
<h6>VOLUNTARY PARTICIPATION/WITHDRAWAL</h6>
<p>Your decision to take part in this Registry is completely voluntary. You are free to choose not to take part in the Registry and may change your mind and withdraw at any time. Your relationship with Us and your care through Us (now or
in the future) will not be affected in any way if you withdraw or refuse to participate. You will not lose any benefits to which you are otherwise entitled.</p>
<h6>WHAT IF YOU DECIDE NOT TO GIVE PERMISSION TO USE AND GIVE OUT YOUR INFORMATION?</h6>
<p>By clicking Submit on this informed consent form and authorization, you are giving permission for Us to obtain, use and share your information as described above. If you refuse to give permission, you are declining to be in this
Registry. <br> Information that is already in the Registry cannot be removed, deleted or withdrawn.</p>
<h6>QUESTIONS</h6>
<p>If you have any additional questions, or if you wish to report a problem that may be related to this Registry, Our Privacy Officer can be reached by email at <a href="mailto:privacy@recoverycoa.com">privacy@recoverycoa.com</a> or at
484-803-9655 during business hours. <br> Do not click Submit on this informed consent form unless you have had a chance to ask questions and have received satisfactory answers to all your questions.</p>
<h5>AGREEMENT TO PARTICIPATE IN REGISTRY AND AUTHORIZATION</h5>
<p>To enroll in the GENETWORx Registry, you or your legal representative must click Submit on this Authorization. By clicking Submit on this page, you are confirming that you have read the information in the “Informed Consent to
Participate in the Medical Record Registry” document and you are voluntarily agreeing to be in the Registry.</p>
<p><strong>By clicking Submit on this Authorization, you authorize any health plan, physician, health care professional, hospital, clinic, laboratory, pharmacy, pharmacy benefits manager, medical facility, health information exchange,
health information aggregator or other health care provider that has provided payment, treatment or services to you to release and disclose the following records to GENETWORx to be incorporated into the Registry:</strong></p>
<p>Any and all information (including personal, health, demographic, claims, billing, pharmacy and medical records) created in the ten years prior to the date of this Authorization or at any time after the date of this Authorization for
as long as this Authorization remains in effect.</p>
<p>The records provided to the Registry will include the following highly protected information (known as Sensitive PHI)</p>
<ul>
<li>Substance abuse records (including alcoholism)</li>
<li>AIDS or HIV treatment records</li>
<li>Mental health services (does not include psychotherapy notes)</li>
<li>Genetic information</li>
</ul>
<p><strong>By clicking Submit on this Authorization, you authorize GENETWORx to use and share your information in the Registry for medical, research, commercial, marketing or other business purposes including, but not limited to, those
described in the Informed Consent.</strong></p>
<p>This Authorization involves the use of a Registry and will remain in effect until you revoke it.<br> You may change your mind and revoke (take back) the right to use your protected health information at any time. However, even if you
revoke this Authorization, the Registry may still maintain, use or disclose information it has already collected about you. If you revoke this Authorization, GENETWORx will no longer collect new information about you for the Registry.
To revoke this Authorization, you must email <a href="mailto:privacy@recoverycoa.com">privacy@recoverycoa.com</a>.</p>
<p>I understand that information disclosed to the Registry pursuant to this Authorization may be subject to re-disclosure and may no longer be protected by federal and state law.</p>
<p>By clicking Submit, you are voluntarily agreeing to be in this Registry and to the use and disclosure of your protected health information as described above. Your health information is being released to GENETWORx at your request. You
understand that your treatment, payment, enrollment or eligibility for benefits does not depend on whether you click Submit on this Authorization and participate in the Registry.</p>
<p>To manage or change opt in preferences or revoke this Authorization, you must call 844-335-2482.</p>
<p>Upon request, you will be given a signed copy of this Authorization form to keep for your personal records.</p>
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<div class="mktoHtmlText mktoHasWidth" style="width: 320px;">
<div class="_updated_consent">
<p>Your privacy is important to us. By clicking Submit, you confirm that you have reviewed our privacy policy and agree to our terms of use and that your information may be shared with RCA and affiliated companies, who may contact you to
keep you updated with important health-related information.</p>
<p>By entering your mobile number and clicking Submit, you also consent that RCA and affiliated companies may send you SMS messages using autodialing technology from our primary messaging code 73529 for health-related information and as
described in our terms of use in our privacy policy. Std. msg & data rates apply. Reply HELP or help, STOP to cancel. Msg freq may vary. Your consent is not required as a condition of purchasing any product, good, or service.</p>
<h5>Informed Consent to Participate in Medical Record Registry</h5>
<p>GENETWORx and its affiliates (“We, Us, Our”) are creating a medical record registry to help Us predict, prevent, and treat disease (the “Registry”). The Registry matches patients’ laboratory test information with medical history
information obtained from health plans, physicians, health care professionals, hospitals, clinics, laboratories, pharmacies, pharmacy benefits managers, and other medical facilities. We will use data analytics, artificial intelligence
and other automated tools to analyze the data in the Registry for various purposes including improving Our patient care and outcomes, lowering costs, recommending products and services to support your health and wellbeing, or sharing
data with other healthcare providers, medical researchers, drug developers, and clinical trial teams to advance medical science.</p>
<h6>SUMMARY OF INFORMATION</h6>
<ul>
<li>This Informed Consent and Authorization asks for your permission to participate in the Registry by allowing Us to obtain, store, use and share your information.</li>
<li>Participation is voluntary and will not affect your care in any way.</li>
<li>We may share your de-identified information with third parties without any further consent or authorization.</li>
<li>Once collected by Us, your information will be stored with industry standard security safeguards.</li>
</ul>
<h6>WHAT IS A REGISTRY?</h6>
<p>A Registry is a collection of information about people who have various diseases or conditions, or who receive various tests or treatments. The Registry holds patient information according to the data security standards of federal and
state law.</p>
<p>This Informed Consent provides you with information that you should know and understand before agreeing to add your information to the Registry. Please read this Informed Consent carefully.</p>
<h6>WHAT INFORMATION IS BEING COLLECTED FOR THE REGISTRY?</h6>
<p>Information (data) will be collected from your health plans, physicians, health care professionals, hospitals, clinics, laboratories, pharmacies, pharmacy benefits managers, and other medical facilities. We will collect health,
demographic, claims, billing, pharmacy and medical records. All information will be collected from your records of the care you have received in the past ten years, are receiving or will be receiving in the future for so long as you
continue to participate in the Registry.</p>
<h6>HOW WILL INFORMATION IN THE REGISTRY BE USED?</h6>
<p>The purpose of this Registry is to help Us predict, prevent, and treat disease. Information in the Registry may be used for medical, research, commercial, marketing or other business purposes including, but not limited to providing
healthcare or care coordination services, communicating with you about diagnostic tests, clinical trials or other healthcare related services that may be of interest based upon your medical history including marketing and promoting our
services and the services of third parties, aggregating and analyzing data to understand or improve Our testing, treatment services, and operations, research to predict, prevent and treat disease(s), de-identifying data to create data
sets that will be shared with third parties such as medical researchers and drug developers to advance medical treatment, for administrative purposes, and for other legally permissible purposes.</p>
<h6>HOW WILL MY HEALTH INFORMATION BE SHARED?</h6>
<p>We may share your identifiable information with Our affiliates under common ownership to use for the same purposes for which We may use your information. We may also share your information with third party service providers performing
services on our behalf. We may share your information for legal purposes including as we deem necessary to respond to a subpoena, regulation, binding order of a data protection agency, legal process, governmental request or other legal
or regulatory process. We may also share your information in business transfers including in connection with a merger, acquisition, the sale of company assets, or in any similar transaction, or to the extent as may be required in the
unlikely event of insolvency bankruptcy, or a receivership. Once your information is de-identified is no longer personal information and can be used by Us and shared with third parties for any purposes, including sale to third parties.
</p>
<h6>HOW LONG IS YOUR PARTICIPATION IN THE REGISTRY?</h6>
<p>With your authorization, we will collect your historic and future health information when you enroll in the Registry. You may stop participating in the Registry at any time.</p>
<h6>WHAT RISKS ARE KNOWN ABOUT BEING IN THE REGISTRY?</h6>
<p>We will comply with the applicable HIPAA standards that protect your health and personal information. However, there is the potential risk your participation in this Registry may expose your information (including health information)
stored in the Registry. <br> There may be other risks that are not known at this time.</p>
<h6>WHAT BENEFIT CAN YOU EXPECT?</h6>
<p>You may receive a benefit from participation in the Registry if We are able to provide you information about diagnostic tests or clinical studies for which you may be eligible. For research related purposes, you will not receive any
direct benefit.</p>
<h6>WHAT ARE THE FINANCIAL CONSIDERATIONS?</h6>
<p><strong>Cost</strong> <br> There will be no cost to you for your participation in this Registry. <br> <strong>Payment for Participation</strong><br> You will not be paid for your participation in this Registry or for any future use of
the information in the Registry.</p>
<h6>VOLUNTARY PARTICIPATION/WITHDRAWAL</h6>
<p>Your decision to take part in this Registry is completely voluntary. You are free to choose not to take part in the Registry and may change your mind and withdraw at any time. Your relationship with Us and your care through Us (now or
in the future) will not be affected in any way if you withdraw or refuse to participate. You will not lose any benefits to which you are otherwise entitled.</p>
<h6>WHAT IF YOU DECIDE NOT TO GIVE PERMISSION TO USE AND GIVE OUT YOUR INFORMATION?</h6>
<p>By clicking Submit on this informed consent form and authorization, you are giving permission for Us to obtain, use and share your information as described above. If you refuse to give permission, you are declining to be in this
Registry. <br> Information that is already in the Registry cannot be removed, deleted or withdrawn.</p>
<h6>QUESTIONS</h6>
<p>If you have any additional questions, or if you wish to report a problem that may be related to this Registry, Our Privacy Officer can be reached by email at <a href="mailto:privacy@recoverycoa.com">privacy@recoverycoa.com</a> or at
484-803-9655 during business hours. <br> Do not click Submit on this informed consent form unless you have had a chance to ask questions and have received satisfactory answers to all your questions.</p>
<h5>AGREEMENT TO PARTICIPATE IN REGISTRY AND AUTHORIZATION</h5>
<p>To enroll in the GENETWORx Registry, you or your legal representative must click Submit on this Authorization. By clicking Submit on this page, you are confirming that you have read the information in the “Informed Consent to
Participate in the Medical Record Registry” document and you are voluntarily agreeing to be in the Registry.</p>
<p><strong>By clicking Submit on this Authorization, you authorize any health plan, physician, health care professional, hospital, clinic, laboratory, pharmacy, pharmacy benefits manager, medical facility, health information exchange,
health information aggregator or other health care provider that has provided payment, treatment or services to you to release and disclose the following records to GENETWORx to be incorporated into the Registry:</strong></p>
<p>Any and all information (including personal, health, demographic, claims, billing, pharmacy and medical records) created in the ten years prior to the date of this Authorization or at any time after the date of this Authorization for
as long as this Authorization remains in effect.</p>
<p>The records provided to the Registry will include the following highly protected information (known as Sensitive PHI)</p>
<ul>
<li>Substance abuse records (including alcoholism)</li>
<li>AIDS or HIV treatment records</li>
<li>Mental health services (does not include psychotherapy notes)</li>
<li>Genetic information</li>
</ul>
<p><strong>By clicking Submit on this Authorization, you authorize GENETWORx to use and share your information in the Registry for medical, research, commercial, marketing or other business purposes including, but not limited to, those
described in the Informed Consent.</strong></p>
<p>This Authorization involves the use of a Registry and will remain in effect until you revoke it.<br> You may change your mind and revoke (take back) the right to use your protected health information at any time. However, even if you
revoke this Authorization, the Registry may still maintain, use or disclose information it has already collected about you. If you revoke this Authorization, GENETWORx will no longer collect new information about you for the Registry.
To revoke this Authorization, you must email <a href="mailto:privacy@recoverycoa.com">privacy@recoverycoa.com</a>.</p>
<p>I understand that information disclosed to the Registry pursuant to this Authorization may be subject to re-disclosure and may no longer be protected by federal and state law.</p>
<p>By clicking Submit, you are voluntarily agreeing to be in this Registry and to the use and disclosure of your protected health information as described above. Your health information is being released to GENETWORx at your request. You
understand that your treatment, payment, enrollment or eligibility for benefits does not depend on whether you click Submit on this Authorization and participate in the Registry.</p>
<p>To manage or change opt in preferences or revoke this Authorization, you must call 844-335-2482.</p>
<p>Upon request, you will be given a signed copy of this Authorization form to keep for your personal records.</p>
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<option value="AE">ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST</option>
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<option value="AP">ARMED FORCES PACIFIC</option>
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<p>Your privacy is important to us. By clicking Submit, you confirm that you have reviewed our privacy policy and agree to our terms of use and that your information may be shared with RCA and affiliated companies, who may
contact you to keep you updated with important health-related information.</p>
<p>By entering your mobile number and clicking Submit, you also consent that RCA and affiliated companies may send you SMS messages using autodialing technology from our primary messaging code 73529 for health-related
information and as described in our terms of use in our privacy policy. Std. msg & data rates apply. Reply HELP or help, STOP to cancel. Msg freq may vary.Your consent is not required as a condition of purchasing any
product, good, or service.</p>
<h5>Informed Consent to Participate in Medical Record Registry</h5>
<p>GENETWORx and its affiliates (“We, Us, Our”) are creating a medical record registry to help Us predict, prevent, and treat disease (the “Registry”). The Registry matches patients’ laboratory test information with medical
history information obtained from health plans, physicians, health care professionals, hospitals, clinics, laboratories, pharmacies, pharmacy benefits managers, and other medical facilities. We will use data analytics,
artificial intelligence and other automated tools to analyze the data in the Registry for various purposes including improving Our patient care and outcomes, lowering costs, recommending products and services to support
your health and wellbeing, or sharing data with other healthcare providers, medical researchers, drug developers, and clinical trial teams to advance medical science.</p>
<h6>SUMMARY OF INFORMATION</h6>
<ul>
<li>This Informed Consent and Authorization asks for your permission to participate in the Registry by allowing Us to obtain, store, use and share your information.</li>
<li>Participation is voluntary and will not affect your care in any way. </li>
<li>We may share your de-identified information with third parties without any further consent or authorization. </li>
<li>Once collected by Us, your information will be stored with industry standard security safeguards.</li>
</ul>
<h6>WHAT IS A REGISTRY?</h6>
<p>A Registry is a collection of information about people who have various diseases or conditions, or who receive various tests or treatments. The Registry holds patient information according to the data security standards
of federal and state law. </p>
<p>This Informed Consent provides you with information that you should know and understand before agreeing to add your information to the Registry. Please read this Informed Consent carefully.</p>
<h6>WHAT INFORMATION IS BEING COLLECTED FOR THE REGISTRY?</h6>
<p>Information (data) will be collected from your health plans, physicians, health care professionals, hospitals, clinics, laboratories, pharmacies, pharmacy benefits managers, and other medical facilities. We will collect
health, demographic, claims, billing, pharmacy and medical records. All information will be collected from your records of the care you have received in the past ten years, are receiving or will be receiving in the future
for so long as you continue to participate in the Registry.</p>
<h6>HOW WILL INFORMATION IN THE REGISTRY BE USED?</h6>
<p>The purpose of this Registry is to help Us predict, prevent, and treat disease. Information in the Registry may be used for medical, research, commercial, marketing or other business purposes including, but not limited to
providing healthcare or care coordination services, communicating with you about diagnostic tests, clinical trials or other healthcare related services that may be of interest based upon your medical history including
marketing and promoting our services and the services of third parties, aggregating and analyzing data to understand or improve Our testing, treatment services, and operations, research to predict, prevent and treat
disease(s), de-identifying data to create data sets that will be shared with third parties such as medical researchers and drug developers to advance medical treatment, for administrative purposes, and for other legally
permissible purposes.</p>
<h6>HOW WILL MY HEALTH INFORMATION BE SHARED?</h6>
<p>We may share your identifiable information with Our affiliates under common ownership to use for the same purposes for which We may use your information. We may also share your information with third party service
providers performing services on our behalf. We may share your information for legal purposes including as we deem necessary to respond to a subpoena, regulation, binding order of a data protection agency, legal process,
governmental request or other legal or regulatory process. We may also share your information in business transfers including in connection with a merger, acquisition, the sale of company assets, or in any similar
transaction, or to the extent as may be required in the unlikely event of insolvency bankruptcy, or a receivership. Once your information is de-identified is no longer personal information and can be used by Us and shared
with third parties for any purposes, including sale to third parties.</p>
<h6>HOW LONG IS YOUR PARTICIPATION IN THE REGISTRY?</h6>
<p>With your authorization, we will collect your historic and future health information when you enroll in the Registry. You may stop participating in the Registry at any time.</p>
<h6>WHAT RISKS ARE KNOWN ABOUT BEING IN THE REGISTRY?</h6>
<p>We will comply with the applicable HIPAA standards that protect your health and personal information. However, there is the potential risk your participation in this Registry may expose your information (including health
information) stored in the Registry. <br>There may be other risks that are not known at this time. </p>
<h6>WHAT BENEFIT CAN YOU EXPECT?</h6>
<p>You may receive a benefit from participation in the Registry if We are able to provide you information about diagnostic tests or clinical studies for which you may be eligible. For research related purposes, you will not
receive any direct benefit. </p>
<h6>WHAT ARE THE FINANCIAL CONSIDERATIONS?</h6>
<p><strong>Cost</strong> <br>There will be no cost to you for your participation in this Registry. <br><strong>Payment for Participation</strong><br>You will not be paid for your participation in this Registry or for any
future use of the information in the Registry.</p>
<h6>VOLUNTARY PARTICIPATION/WITHDRAWAL</h6>
<p>Your decision to take part in this Registry is completely voluntary. You are free to choose not to take part in the Registry and may change your mind and withdraw at any time. Your relationship with Us and your care
through Us (now or in the future) will not be affected in any way if you withdraw or refuse to participate. You will not lose any benefits to which you are otherwise entitled.</p>
<h6>WHAT IF YOU DECIDE NOT TO GIVE PERMISSION TO USE AND GIVE OUT YOUR INFORMATION?</h6>
<p>By clicking Submit on this informed consent form and authorization, you are giving permission for Us to obtain, use and share your information as described above. If you refuse to give permission, you are declining to be
in this Registry. <br>Information that is already in the Registry cannot be removed, deleted or withdrawn. </p>
<h6>QUESTIONS</h6>
<p>If you have any additional questions, or if you wish to report a problem that may be related to this Registry, Our Privacy Officer can be reached by email at
<a href="mailto:privacy@recoverycoa.com">privacy@recoverycoa.com</a> or at 484-803-9655 during business hours. <br> Do not click Submit on this informed consent form unless you have had a chance to ask questions and have
received satisfactory answers to all your questions. </p>
<h5>AGREEMENT TO PARTICIPATE IN REGISTRY AND AUTHORIZATION</h5>
<p>To enroll in the GENETWORx Registry, you or your legal representative must click Submit on this Authorization. By clicking Submit on this page, you are confirming that you have read the information in the “Informed
Consent to Participate in the Medical Record Registry” document and you are voluntarily agreeing to be in the Registry.</p>
<p><strong>By clicking Submit on this Authorization, you authorize any health plan, physician, health care professional, hospital, clinic, laboratory, pharmacy, pharmacy benefits manager, medical facility, health information
exchange, health information aggregator or other health care provider that has provided payment, treatment or services to you to release and disclose the following records to GENETWORx to be incorporated into the
Registry:</strong></p>
<p>Any and all information (including personal, health, demographic, claims, billing, pharmacy and medical records) created in the ten years prior to the date of this Authorization or at any time after the date of this
Authorization for as long as this Authorization remains in effect. </p>
<p>The records provided to the Registry will include the following highly protected information (known as Sensitive PHI)</p>
<ul>
<li>Substance abuse records (including alcoholism)</li>
<li>AIDS or HIV treatment records</li>
<li>Mental health services (does not include psychotherapy notes)</li>
<li>Genetic information</li>
</ul>
<p><strong>By clicking Submit on this Authorization, you authorize GENETWORx to use and share your information in the Registry for medical, research, commercial, marketing or other business purposes including, but not
limited to, those described in the Informed Consent.</strong></p>
<p>This Authorization involves the use of a Registry and will remain in effect until you revoke it.<br>You may change your mind and revoke (take back) the right to use your protected health information at any time. However,
even if you revoke this Authorization, the Registry may still maintain, use or disclose information it has already collected about you. If you revoke this Authorization, GENETWORx will no longer collect new information
about you for the Registry. To revoke this Authorization, you must email <a href="mailto:privacy@recoverycoa.com">privacy@recoverycoa.com</a>.</p>
<p>I understand that information disclosed to the Registry pursuant to this Authorization may be subject to re-disclosure and may no longer be protected by federal and state law.</p>
<p>By clicking Submit, you are voluntarily agreeing to be in this Registry and to the use and disclosure of your protected health information as described above. Your health information is being released to GENETWORx at your
request. You understand that your treatment, payment, enrollment or eligibility for benefits does not depend on whether you click Submit on this Authorization and participate in the Registry.</p>
<p>To manage or change opt in preferences or revoke this Authorization, you must call 844-335-2482.</p>
<p>Upon request, you will be given a signed copy of this Authorization form to keep for your personal records.</p>
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<input type="tel" value="" class="ninja-forms-field nf-element" id="nf-field-61" name="phone" autocomplete="tel" placeholder="(555) 555-5555" aria-invalid="false" aria-describedby="nf-error-61"
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<input type="email" value="" class="ninja-forms-field nf-element" id="nf-field-60" name="email" autocomplete="email" placeholder="Email Address" aria-invalid="false" aria-describedby="nf-error-60"
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<div class="nf-field-label"><label for="nf-field-65" id="nf-label-field-65" class="">Zip Code </label></div>
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<input type="text" value="" class="ninja-forms-field nf-element" id="nf-field-65" name="zip" autocomplete="postal-code" placeholder="12345" aria-invalid="false" aria-describedby="nf-error-65"
aria-labelledby="nf-label-field-65">
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<p>Your privacy is important to us. By clicking Submit, you confirm that you have reviewed our privacy policy and agree to our terms of use and that your information may be shared with RCA and affiliated companies, who may
contact you to keep you updated with important health-related information.</p>
<p>By entering your mobile number and clicking Submit, you also consent that RCA and affiliated companies may send you SMS messages using autodialing technology from our primary messaging code 73529 for health-related
information and as described in our terms of use in our privacy policy. Std. msg & data rates apply. Reply HELP or help, STOP to cancel. Msg freq may vary.Your consent is not required as a condition of purchasing any
product, good, or service.</p>
<h5>Informed Consent to Participate in Medical Record Registry</h5>
<p>GENETWORx and its affiliates (“We, Us, Our”) are creating a medical record registry to help Us predict, prevent, and treat disease (the “Registry”). The Registry matches patients’ laboratory test information with medical
history information obtained from health plans, physicians, health care professionals, hospitals, clinics, laboratories, pharmacies, pharmacy benefits managers, and other medical facilities. We will use data analytics,
artificial intelligence and other automated tools to analyze the data in the Registry for various purposes including improving Our patient care and outcomes, lowering costs, recommending products and services to support
your health and wellbeing, or sharing data with other healthcare providers, medical researchers, drug developers, and clinical trial teams to advance medical science.</p>
<h6>SUMMARY OF INFORMATION</h6>
<ul>
<li>This Informed Consent and Authorization asks for your permission to participate in the Registry by allowing Us to obtain, store, use and share your information.</li>
<li>Participation is voluntary and will not affect your care in any way. </li>
<li>We may share your de-identified information with third parties without any further consent or authorization. </li>
<li>Once collected by Us, your information will be stored with industry standard security safeguards.</li>
</ul>
<h6>WHAT IS A REGISTRY?</h6>
<p>A Registry is a collection of information about people who have various diseases or conditions, or who receive various tests or treatments. The Registry holds patient information according to the data security standards
of federal and state law. </p>
<p>This Informed Consent provides you with information that you should know and understand before agreeing to add your information to the Registry. Please read this Informed Consent carefully.</p>
<h6>WHAT INFORMATION IS BEING COLLECTED FOR THE REGISTRY?</h6>
<p>Information (data) will be collected from your health plans, physicians, health care professionals, hospitals, clinics, laboratories, pharmacies, pharmacy benefits managers, and other medical facilities. We will collect
health, demographic, claims, billing, pharmacy and medical records. All information will be collected from your records of the care you have received in the past ten years, are receiving or will be receiving in the future
for so long as you continue to participate in the Registry.</p>
<h6>HOW WILL INFORMATION IN THE REGISTRY BE USED?</h6>
<p>The purpose of this Registry is to help Us predict, prevent, and treat disease. Information in the Registry may be used for medical, research, commercial, marketing or other business purposes including, but not limited to
providing healthcare or care coordination services, communicating with you about diagnostic tests, clinical trials or other healthcare related services that may be of interest based upon your medical history including
marketing and promoting our services and the services of third parties, aggregating and analyzing data to understand or improve Our testing, treatment services, and operations, research to predict, prevent and treat
disease(s), de-identifying data to create data sets that will be shared with third parties such as medical researchers and drug developers to advance medical treatment, for administrative purposes, and for other legally
permissible purposes.</p>
<h6>HOW WILL MY HEALTH INFORMATION BE SHARED?</h6>
<p>We may share your identifiable information with Our affiliates under common ownership to use for the same purposes for which We may use your information. We may also share your information with third party service
providers performing services on our behalf. We may share your information for legal purposes including as we deem necessary to respond to a subpoena, regulation, binding order of a data protection agency, legal process,
governmental request or other legal or regulatory process. We may also share your information in business transfers including in connection with a merger, acquisition, the sale of company assets, or in any similar
transaction, or to the extent as may be required in the unlikely event of insolvency bankruptcy, or a receivership. Once your information is de-identified is no longer personal information and can be used by Us and shared
with third parties for any purposes, including sale to third parties.</p>
<h6>HOW LONG IS YOUR PARTICIPATION IN THE REGISTRY?</h6>
<p>With your authorization, we will collect your historic and future health information when you enroll in the Registry. You may stop participating in the Registry at any time.</p>
<h6>WHAT RISKS ARE KNOWN ABOUT BEING IN THE REGISTRY?</h6>
<p>We will comply with the applicable HIPAA standards that protect your health and personal information. However, there is the potential risk your participation in this Registry may expose your information (including health
information) stored in the Registry. <br>There may be other risks that are not known at this time. </p>
<h6>WHAT BENEFIT CAN YOU EXPECT?</h6>
<p>You may receive a benefit from participation in the Registry if We are able to provide you information about diagnostic tests or clinical studies for which you may be eligible. For research related purposes, you will not
receive any direct benefit. </p>
<h6>WHAT ARE THE FINANCIAL CONSIDERATIONS?</h6>
<p><strong>Cost</strong> <br>There will be no cost to you for your participation in this Registry. <br><strong>Payment for Participation</strong><br>You will not be paid for your participation in this Registry or for any
future use of the information in the Registry.</p>
<h6>VOLUNTARY PARTICIPATION/WITHDRAWAL</h6>
<p>Your decision to take part in this Registry is completely voluntary. You are free to choose not to take part in the Registry and may change your mind and withdraw at any time. Your relationship with Us and your care
through Us (now or in the future) will not be affected in any way if you withdraw or refuse to participate. You will not lose any benefits to which you are otherwise entitled.</p>
<h6>WHAT IF YOU DECIDE NOT TO GIVE PERMISSION TO USE AND GIVE OUT YOUR INFORMATION?</h6>
<p>By clicking Submit on this informed consent form and authorization, you are giving permission for Us to obtain, use and share your information as described above. If you refuse to give permission, you are declining to be
in this Registry. <br>Information that is already in the Registry cannot be removed, deleted or withdrawn. </p>
<h6>QUESTIONS</h6>
<p>If you have any additional questions, or if you wish to report a problem that may be related to this Registry, Our Privacy Officer can be reached by email at
<a href="mailto:privacy@recoverycoa.com">privacy@recoverycoa.com</a> or at 484-803-9655 during business hours. <br> Do not click Submit on this informed consent form unless you have had a chance to ask questions and have
received satisfactory answers to all your questions. </p>
<h5>AGREEMENT TO PARTICIPATE IN REGISTRY AND AUTHORIZATION</h5>
<p>To enroll in the GENETWORx Registry, you or your legal representative must click Submit on this Authorization. By clicking Submit on this page, you are confirming that you have read the information in the “Informed
Consent to Participate in the Medical Record Registry” document and you are voluntarily agreeing to be in the Registry.</p>
<p><strong>By clicking Submit on this Authorization, you authorize any health plan, physician, health care professional, hospital, clinic, laboratory, pharmacy, pharmacy benefits manager, medical facility, health information
exchange, health information aggregator or other health care provider that has provided payment, treatment or services to you to release and disclose the following records to GENETWORx to be incorporated into the
Registry:</strong></p>
<p>Any and all information (including personal, health, demographic, claims, billing, pharmacy and medical records) created in the ten years prior to the date of this Authorization or at any time after the date of this
Authorization for as long as this Authorization remains in effect. </p>
<p>The records provided to the Registry will include the following highly protected information (known as Sensitive PHI)</p>
<ul>
<li>Substance abuse records (including alcoholism)</li>
<li>AIDS or HIV treatment records</li>
<li>Mental health services (does not include psychotherapy notes)</li>
<li>Genetic information</li>
</ul>
<p><strong>By clicking Submit on this Authorization, you authorize GENETWORx to use and share your information in the Registry for medical, research, commercial, marketing or other business purposes including, but not
limited to, those described in the Informed Consent.</strong></p>
<p>This Authorization involves the use of a Registry and will remain in effect until you revoke it.<br>You may change your mind and revoke (take back) the right to use your protected health information at any time. However,
even if you revoke this Authorization, the Registry may still maintain, use or disclose information it has already collected about you. If you revoke this Authorization, GENETWORx will no longer collect new information
about you for the Registry. To revoke this Authorization, you must email <a href="mailto:privacy@recoverycoa.com">privacy@recoverycoa.com</a>.</p>
<p>I understand that information disclosed to the Registry pursuant to this Authorization may be subject to re-disclosure and may no longer be protected by federal and state law.</p>
<p>By clicking Submit, you are voluntarily agreeing to be in this Registry and to the use and disclosure of your protected health information as described above. Your health information is being released to GENETWORx at your
request. You understand that your treatment, payment, enrollment or eligibility for benefits does not depend on whether you click Submit on this Authorization and participate in the Registry.</p>
<p>To manage or change opt in preferences or revoke this Authorization, you must call 844-335-2482.</p>
<p>Upon request, you will be given a signed copy of this Authorization form to keep for your personal records.</p>
</div>
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GENETWORx and its affiliates (“We, Us, Our”) are creating a medical record
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This Informed Consent provides you with information that you should know and
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WHAT INFORMATION IS BEING COLLECTED FOR THE REGISTRY?
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By clicking Submit on this informed consent form and authorization, you are
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Information that is already in the Registry cannot be removed, deleted or
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If you have any additional questions, or if you wish to report a problem that
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Do not click Submit on this informed consent form unless you have had a chance
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AGREEMENT TO PARTICIPATE IN REGISTRY AND AUTHORIZATION
To enroll in the GENETWORx Registry, you or your legal representative must click
Submit on this Authorization. By clicking Submit on this page, you are
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agreeing to be in the Registry.
By clicking Submit on this Authorization, you authorize any health plan,
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GENETWORx to be incorporated into the Registry:
Any and all information (including personal, health, demographic, claims,
billing, pharmacy and medical records) created in the ten years prior to the
date of this Authorization or at any time after the date of this Authorization
for as long as this Authorization remains in effect.
The records provided to the Registry will include the following highly protected
information (known as Sensitive PHI)
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By clicking Submit on this Authorization, you authorize GENETWORx to use and
share your information in the Registry for medical, research, commercial,
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described in the Informed Consent.
This Authorization involves the use of a Registry and will remain in effect
until you revoke it.
You may change your mind and revoke (take back) the right to use your protected
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the Registry may still maintain, use or disclose information it has already
collected about you. If you revoke this Authorization, GENETWORx will no longer
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Authorization, you must email privacy@recoverycoa.com.
I understand that information disclosed to the Registry pursuant to this
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federal and state law.
By clicking Submit, you are voluntarily agreeing to be in this Registry and to
the use and disclosure of your protected health information as described above.
Your health information is being released to GENETWORx at your request. You
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WHY PHARMACOGENOMICS ("PGX")?
GENETWORx was created with the targeted focus of impacting and improving
people’s lives by empowering them and their physicians with the information and
medicinal results they need through pharmacogenomic testing.
GENETWORx Laboratory recognized a gap in healthcare services between the lab and
pharmacy: Every person’s body and genetic make-up is different—and therefore why
shouldn’t their medications follow suit? Knowing a person’s genetic makeup can
indicate how their body will process an metabolize drugs. The metabolism of a
drug can have important consequences on its therapeutic effect or its toxicity.
For instance, whether the drug will be metabolized by the body too quickly or
too slowly to be effective.
Without knowing which medication will be the optimal choice, it can be trial and
error for a physician—they pick a medication based on their past experience or
drug prescribing information in the hope that the patient’s body responds
effectively to it. Personalized medicine using pharmacogenomic testing takes
some of the guesswork out of medication effectiveness.
GET STARTED
WHAT IS PHARMACOGENOMICS ("PGX")?
Pharmacogenomics is the study of how DNA impacts individual responses to
medication.
* Pharmacogenomics is able to improve clinical outcomes as well as provide
financial value to the health system. There are many compelling studies that
found significant cost-savings value from introducing pharmacogenomics to
physicians and patients.1
* GENETWORx is an expert in pharmacogenomics lab testing, detecting genetic
differences that affect the metabolism of therapeutic medications and the
possibility for adverse events.2
GET STARTED
Having a list of medications and a list of potential medication-medication
interactions, gene-medication interactions, and medication-gene-medication
interactions, along with this new genetic information, gives a prescriber a
better understanding of why their patient may respond to a medication in a
particular way. In other words: A more effective medication the first time
around, eliminating the time, energy, and money wasted trying to find the
“right” medication for a patient.
GENETWORx is a pharmacogenomic lab and tests 30 genes to help identify mutations
that may affect a person’s metabolism and/or response to medications. Once the
pharmacogenomic analysis, conducted via a simple cheek swab sample, is complete,
a Personalized Medication Report is reviewed by a pharmacist at GENETWORx and
prepared for the prescriber so that they can identify potential gene-medication
interactions, medication-medication interactions, as well as
medication-gene-medication interactions. GENETWORx reports provide a
pharmacogenomic analysis along with a Personalized Medication Guide, that list
medications by specialty in categories of: Use as Directed, Use with Caution, or
Recommend Alternative Medication. This list can be used for helping a prescriber
choose new or alternative medications for their patient. The report is a
powerful tool to help healthcare providers and their patients determine the best
course of treatment.
GET STARTED
> Dear Ms. Helber,
>
> What a wonderful genetic testing service GENETWORx provides, and what great
> employees you have there! My husband, Mark, had genetic testing with you
> through his orthopedist’s office 6 years ago, as he was heading for a knee
> replacement in his early 50s (25 years of serious running was not a good
> thing). Because of his medication allergies, the orthopedist decided to do
> genetic testing to check on the pain meds to be prescribed. As a result, he
> canceled Mark’s surgery because all the meds he could prescribe for the
> post-surgery pain were contraindicated. Mark turned out to be a poor CYP2D6
> metabolizer, and nothing was going to reduce the pain sufficiently for him to
> complete rehab. The orthopedist said that he didn’t want to leave Mark in
> worse shape than before the surgery, which was in hindsight a good thing.
>
> All that genetic information six years ago was wonderful to have, and Stacey
> B. our GENETWORx pharmacist was terrific in helping us decipher it. Mark’s had
> more issues since, especially as he has intractable migraines and is
> constantly taking pain meds, so we and his latest neurologist decided to redo
> the genetic testing. Stacey said GENETWORx had increased the number of genes
> it tests for. Another super-helpful choice on our part! When we had access to
> it, we both thoroughly read through and highlighted specific meds he should
> avoid, and yep, he’d been prescribed some of them in the intervening six
> years, with less than positive results.
>
> Stacey has been a treasure during the past several months, helping us check on
> additional meds, explaining Promedications versus non Promedications, and just
> generally being amazing. At this point there have been a number of emails
> between us, and I can really tell that she’s not only an excellent pharmacist
> but a truly wonderful person, and a great asset to you and GENETWORx. One
> critical thing, especially during these times of working remote, is that
> Stacey can write complete, thoroughly explanatory emails, which is not a
> common skill. We’ve been really appreciative to have her assistance and her
> kindness as we negotiate Mark’s worsening health.
>
> The last months have been a difficult time for everyone, so Mark and I both
> immensely appreciate the services you still provide at GENETWORx. Thanks
> again, keep up the good work, and stay well.”
>
> - Lynn
MEDICATION MANAGEMENT TEST MENU
Cytochrome P450 Enzymes: The Cytochrome P450 enzyme system is one of several
metabolic systems which plays a major role in the metabolism of medications. A
medication that is metabolized by a certain enzyme is a substrate of that
enzyme. Some medications are also promedications of a certain enzyme, meaning it
becomes “active” in the body after it is metabolized. Mutations in the specific
enzymes can cause individuals to metabolize medications at different rates.
Metabolic rates are classified for each enzyme as Normal Metabolizer, Rapid
Metabolizer, Intermediate Metabolizer and Poor Metabolizer.
Search:
GeneDescription Cytochrome P450 EnzymesThe Cytochrome P450 enzyme system is one
of several metabolic systems which plays a major role in the metabolism of
medication. A medication that is metabolized by a certain enzyme is a substrate
of that enzyme. Some medications are also pro medications of a certain enzyme,
meaning it becomes “active” in the body after it is metabolized. Mutations in
the specific enzymes can cause individuals to metabolize medications at
different rates. Metabolic rates are classified for each enzyme as Normal
Metabolizer, Rapid Metabolizer, Intermediate Metabolizer and Poor Metabolizer.
CYP1A2This gene encodes for the formation of CYP1A2 enzymes influencing
variability in metabolism of approximately 9% of medications. Some examples of
CYP1A2 substrates are caffeine, clozapine, cyclobenzaprine, lidocaine,
olanzapine, propranolol, ropivacaine, tizanidine, zileuton. CYP2B6This gene
encodes for the formation of CYP2B6 enzymes influencing variability in
metabolism of approximately 7% of medications. Some examples of CYP2B6
substrates are bupropion, efavirenz, irinotecan, ifosfamide, methadone,
cyclophosphamide, ketamine, nevirapine, propofol, selegiline, testosterone.
CYP2C19This gene encodes for the formation of CYP2C19 enzymes influencing
variability in metabolism of approximately 10 to 15% of medications. Some
examples of 2C19 substrates are esomeprazole, lansoprazole, citalopram,
escitalopram, amitriptyline, diazepam, phenytoin, carisoprodol, clopidogrel,
sertraline, pantoprazole, moclobemide, imipramine, voriconazole. CYP2C8This gene
encodes for the formation of CYP2C8 enzymes influencing variability in
metabolism of approximately 5% of medication. Some examples of CYP2C8 substrates
are amiodarone, paclitaxel, pioglitazone, rosiglitazone, repaglinide, torsemide.
CYP2C9This gene encodes for the formation of CYP2C9 enzymes influencing
variability in metabolism of approximately 15% of medication. Some examples of
CYP2C9 substrates are meloxicam, losartan, glipizide, glyburide, phenytoin,
warfarin and torsemide. CYP2D6This gene encodes for the formation of CYP2D6
enzymes influencing variability in metabolism of approximately 25-30% of
medication. Some examples of CYP2D6 substrates are fluoxetine, paroxetine,
aripiprazole, risperidone, duloxetine, amphetamine, metoprolol, tamoxifen and
codeine. CYP3A4/CYP3A5 This gene encodes for the formation of CYP3A4/5 enzymes
influencing variability in metabolism of approximately 40% of medications. Some
examples of CYP3A4/5 substrates are clarithromycin, clonazepam, diazepam,
etravirine, loratadine, diltiazem, simvastatin, carbamazepine, cilostazol,
aripiprazole, salmeterol, tamoxifen, trazodone, vemurafenib, zolpidem.
Showing 1 to 8 of 8 entries
ADDITIONAL PHARMACOKINETIC AND PHARMACODYNAMIC GENES
Search:
GeneDescription ABCB1ABCB1 (ATP binding cassette subfamily B) encodes for the
formation of intestinal efflux transporter P-glycoprotein and is a major
contributor in the intestinal absorption of ABCB1 substrates. Poor and
intermediate ABCB1 phenotypes may have an increased likelihood of therapeutic
failure compared to patients with a normal phenotype and taking ABCB1
substrates. Example Substrates: copidogrel, aliskiren, ambrisentan, colchicine,
dabigatran etexilate, digoxin, everolimus, fexofenadine, imatinib, lapatinib,
maraviroc, nilotinib, posaconazole, ranolazine, saxagliptin, sirolimus,
sitagliptin, talinolol, tolvaptan, topotecan. ABCG2 ABCG2 (ATP binding cassette
subfamily G2) encodes for the formation of intestine, liver, placenta, and the
blood–brain barrier efflux transporters in the form of homodimers in the plasma
membrane and actively extrudes a wide variety of chemically unrelated compounds
from the cells. This protein protects our cells and tissues against various
xenobiotics. Example Substrates: daunorubicin, doxorubicin, topotecan,
rosuvastatin, sulfasalazine ADRA2A ADRA2A (Adrenoceptor Alpha 2A) gene plays a
critical role in regulating neurotransmitter release from sympathetic nerves and
from neurons that release the hormone and neurotransmitter norepinephrine in the
central nervous system. Variants in the gene have been linked to the clinical
effectiveness of ADHD medications. Additional studies have shown other variants
associated with an increased risk for hypertension. Variants in ADRA2A are
thought to be present in a quarter of the caucasian population. APOEAPOE
(Apolipoprotein E) gene encodes for the formation of apolipoprotein E which
combines with fats (lipids) in the body to form lipoproteins. Lipoproteins are
responsible for forming cholesterol and other fats found through the
bloodstream. Studies have shown individuals who carry one or more copies of
APOE-4 have a reduced therapeutic response to lipid-lowering medications
(statins). The APOE-4 allele has shown to have an increased risk of high LDL
cholesterol and both cardiovascular disease and Alzheimer’s disease.
COMTCatechol-O-Methyltransferase (COMT) is an enzyme that inactivates
catecholamines, such as epinephrine, norepinephrine and dopamine. COMT regulates
cognitive function, memory, mood and pain perception. Up to 60% of depressed
patients do not respond completely to antidepressants and up to 30% do not
respond at all. A variety of medications, such as nicotine replacement therapy
(NRT), entacapone, opioids, SSRIs and antipsychotics, may be directly or
indirectly impacted by the change in catecholamines inactivation. DBH Dopamine
Beta-Hydroxylase (DBH) gene encodes for the formation dopamine beta-hydroxylase
protein. DBH protein catalyzes the hydroxylase of dopamine to norepinephrine and
is primarily located in the adrenal medulla and in postganglionic sympathetic
neurons. Variations in the DBH gene have been shown to be a risk factor for
psychiatric disorders and addiction. ANKK1/
DRD2/Taq1AANKK1 gene is linked to dopamine receptor D2 (DRD2). Dopamine (DA) is
a neurotransmitter in the brain, which controls feeling of wellbeing. This
sensation results from dopamine and other neurotransmitters such as serotonin,
opioids, and other brain chemicals.
Dopamine increases the motivation for food cravings and appetite mediation. The
DRD2/ANKK1-Taq1A polymorphism modulates the density of the DRD2 dopamine
receptors. Carriers of the A1 allele have shown up to 30% reduced receptor
capacity, correlating to a predisposition for individuals to seek addictive
behaviors or substances to compensate this deficiency in the dopaminergic
system; Examples include binge eating (e.g. fat, refined carbohydrates, salt,
caffeine, etc.) and compulsive and impulsive behaviors (e.g. sexual activity,
gambling and use of alcohol, medications, opiates, tobacco etc.). DPYDThis gene
encodes the dihydropyrimidine dehydrogenase protein, the initial and rate
limiting enzyme in the three-step pathway of uracil and thymidine catabolism and
the pathway leading to the formation of beta-alanine. The DPYD protein is
responsible for degrading fluoropyrimidines, such as 5-fluorouracil,
capecitabine, and tegafur. Decreased DPYD activity is associated with a greater
than four-fold risk of severe or fatal toxicity from standard doses of 5FU.
GRIK4GRIK4 (glutamate receptor, ionotropic, kainate 4) is the gene that encodes
KA1, a type of neurotransmitter receptor subunit that joins together with other
subunits to form glutamate receptors. These receptors are located on cells in
the brain and are involved in enhancing cell-cell communication, which may play
a role in major depressive disorder. This type of receptor primarily binds
glutamate, a major neurotransmitter involved in developmental growth, learning
and memory. Although the effect of variations in GRIK4 on KA1 function and
expression are not fully known, KA1 may play a role in modulating the
therapeutic effect of antidepressants. Mutations in GRIK4 may impact patients
with major depressive disorder who take citalopram. Patients being considered
for citalopram initiation or who have experienced treatment resistance or
failure with citalopram should be considered for GRIK4 testing. HTR2AHTR2A is a
post-synaptic serotonin receptor that binds serotonin and is involved in
amplification of excitatory signals to other neurons in the brain. Polymorphisms
of this gene may affect antidepressant and antipsychotic response and risk of
adverse effects. HTR2A polymorphisms can help predict which patients may be more
likely to experience SSRI-induced adverse effects and provide supplemental
information to determine if patients will adequately respond to therapy. HTR2C
HTR2C is a G-protein coupled serotonin receptor located on the X chromosome.
Mutations in this receptor may be useful in predicting which patients are at
risk for adverse events from medications such as olanzapine. IL28B IL28B, also
called interferon, lambda 3, is the strongest baseline predictor of response to
PEG-interferon-alpha-containing regimens in HCV genotype 1 patients. Patients
with the favorable response genotype increased likelihood of response (higher
SVR rate) to PEG-interferon-alpha-containing regimens as compared to patients
with unfavorable response genotype. Consider implications before initiating
PEG-IFN alpha and RBV containing regimens. ITGB3ITGB3 encodes the gene for beta
3 integrin. Mutations in this gene influence the efficacy of medications such as
clopidogrel. OPRK1Kappa 1 opioid receptor (OPRK1) is a pharmacodynamic receptor
that is partly responsible for opioid effectiveness and is associated with pain
sensitivity, substance dependence and abuse. OPRM1Mu 1 opioid receptor (OPRM1)
is a pharmacodynamic receptor that is partly responsible for opioid
effectiveness and is associated with pain sensitivity, substance dependence and
abuse. The most analyzed genetic variants have shown an association with opioid
effectiveness, naltrexone efficacy in the treatment of alcoholism and addiction
risk to opioids, including heroin. Patients beginning naltrexone treatment for
alcohol dependence would be good candidates for OPRM1 testing. Testing can also
help predict opioid response and dose requirements. Testing can also help assess
opioid addiction risk. SLCO1B1SLCO1B1 (also known as OAT1B1) encodes for the
formation of influx transporter that moves medications into cells. Variations in
SLCO1B1 may affect the blood levels of medications that are substrates for this
transporter. Some examples of SLCO1B1 transported medications are: atorvastatin,
bosentan, ezetimibe, fluvastatin, glyburide, SN-38 (active metabolite of
irinotecan), rosuvastatin, simvastatin acid, pitavastatin, pravastatin,
repaglinide, rifampin, valsartan, olmesartan UGT1A1Uridine diphosphate
(UDP)-glucuronosyl transferase 1A1 (UGT1A1) is responsible for bilirubin
conjugation with glucuronic acid. UGT1A1 is a pharmacogene and patients with
reduced UGT1A1 enzyme activity are at risk for adverse outcomes with certain
medications. The FDA medication labels for nilotinib, pazopanib, and belinostat
all contain warnings for an increased risk (incidence) of adverse outcomes in
patients who have UGT1A1 alleles associated with reduced activity.
UGT2B15UDP-glucuronosyltransferase 2B15 is an enzyme that in humans is encoded
by the UGT2B15 gene. The UGTs are of major importance in the conjugation and
subsequent elimination of potentially toxic xenobiotics and endogenous
compounds. Polymorphisms have been associated with variation in medication
metabolism, including some medications used for mental health disorders, PPAR
agonist (Thiazolidinediones), and clearance of oxazepam or lorazepam.
VKORC1Vitamin K epoxide complex subunit 1 (VKORC1) is the enzyme that activates
Vitamin K. Mutations in VKORC1 are associated with deficiencies in
vitamin-K-dependent clotting factors. A particular VKORC1 variant (-1939G>A)
leads to increased sensitivity to warfarin. VKORC1 mutation accounts for 25-44%
of warfarin dose variability and is typically tested for at the same time as 2C9
when warfarin is being considered. Factor II Prothrombin Genetic ProfilingThis
test detects a genetic change in the Factor II gene called Factor II
Prothrombin. Patients with this Prothrombin variant are at an increased risk of
blood clot formation (thrombosis) when exposed to other risk factors such as
smoking, pregnancy, obesity, oral contraceptive use, and immobility. The risk is
approximately 3-10 times higher in individuals who have one copy of the genetic
variant. The risk in people who carry two copies of the genetic variant is
unknown. Individuals who do not have a Factor II Prothrombin mutation may still
be at increased risk. Other changes in the Factor II gene that were not tested
for, changes in other genes, and non-genetic factors may still increase your
risk for thrombosis. Factor V Leiden Mutation TestThis test detects a genetic
change in the Factor V gene called Factor V Leiden. Individuals who have this
variant are at an increased risk of blood clot formation. This risk is
approximately 2-10 times higher in individuals who have one copy of the genetic
variant, and greater than 10 times higher for individuals who carry two copies
of the genetic variant. Individuals who do not have the Factor V Leiden mutation
may still be at increased risk. Other changes in the Factor V gene that were not
tested for, changes in other genes, and non-genetic factors may still increase
your risk for thrombosis. MTHFR Mutation TestingThis test detects two genetic
changes in the MTHFR gene. Individuals who are found to have two mutations are
at an increased risk for serious blood clot formation. Individuals who have only
one or no copies of either genetic change in the MTHFR gene may still be at
increased risk. Other changes in the MTHFR gene that were not tested for,
changes in other genes, and non-genetic factors may still increase your risk for
thrombosis.
Showing 1 to 22 of 22 entries
REFERENCES
* [1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068890/
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GENETWORx and its affiliates (“We, Us, Our”) are creating a medical record
registry to help Us predict, prevent, and treat disease (the “Registry”). The
Registry matches patients’ laboratory test information with medical history
information obtained from health plans, physicians, health care professionals,
hospitals, clinics, laboratories, pharmacies, pharmacy benefits managers, and
other medical facilities. We will use data analytics, artificial intelligence
and other automated tools to analyze the data in the Registry for various
purposes including improving Our patient care and outcomes, lowering costs,
recommending products and services to support your health and wellbeing, or
sharing data with other healthcare providers, medical researchers, drug
developers, and clinical trial teams to advance medical science.
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participate in the Registry by allowing Us to obtain, store, use and share
your information.
* Participation is voluntary and will not affect your care in any way.
* We may share your de-identified information with third parties without any
further consent or authorization.
* Once collected by Us, your information will be stored with industry standard
security safeguards.
WHAT IS A REGISTRY?
A Registry is a collection of information about people who have various diseases
or conditions, or who receive various tests or treatments. The Registry holds
patient information according to the data security standards of federal and
state law.
This Informed Consent provides you with information that you should know and
understand before agreeing to add your information to the Registry. Please read
this Informed Consent carefully.
WHAT INFORMATION IS BEING COLLECTED FOR THE REGISTRY?
Information (data) will be collected from your health plans, physicians, health
care professionals, hospitals, clinics, laboratories, pharmacies, pharmacy
benefits managers, and other medical facilities. We will collect health,
demographic, claims, billing, pharmacy and medical records. All information will
be collected from your records of the care you have received in the past ten
years, are receiving or will be receiving in the future for so long as you
continue to participate in the Registry.
HOW WILL INFORMATION IN THE REGISTRY BE USED?
The purpose of this Registry is to help Us predict, prevent, and treat disease.
Information in the Registry may be used for medical, research, commercial,
marketing or other business purposes including, but not limited to providing
healthcare or care coordination services, communicating with you about
diagnostic tests, clinical trials or other healthcare related services that may
be of interest based upon your medical history including marketing and promoting
our services and the services of third parties, aggregating and analyzing data
to understand or improve Our testing, treatment services, and operations,
research to predict, prevent and treat disease(s), de-identifying data to create
data sets that will be shared with third parties such as medical researchers and
drug developers to advance medical treatment, for administrative purposes, and
for other legally permissible purposes.
HOW WILL MY HEALTH INFORMATION BE SHARED?
We may share your identifiable information with Our affiliates under common
ownership to use for the same purposes for which We may use your information. We
may also share your information with third party service providers performing
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your information is de-identified is no longer personal information and can be
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With your authorization, we will collect your historic and future health
information when you enroll in the Registry. You may stop participating in the
Registry at any time.
WHAT RISKS ARE KNOWN ABOUT BEING IN THE REGISTRY?
We will comply with the applicable HIPAA standards that protect your health and
personal information. However, there is the potential risk your participation in
this Registry may expose your information (including health information) stored
in the Registry.
There may be other risks that are not known at this time.
WHAT BENEFIT CAN YOU EXPECT?
You may receive a benefit from participation in the Registry if We are able to
provide you information about diagnostic tests or clinical studies for which you
may be eligible. For research related purposes, you will not receive any direct
benefit.
WHAT ARE THE FINANCIAL CONSIDERATIONS?
Cost
There will be no cost to you for your participation in this Registry.
Payment for Participation
You will not be paid for your participation in this Registry or for any future
use of the information in the Registry.
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Your decision to take part in this Registry is completely voluntary. You are
free to choose not to take part in the Registry and may change your mind and
withdraw at any time. Your relationship with Us and your care through Us (now or
in the future) will not be affected in any way if you withdraw or refuse to
participate. You will not lose any benefits to which you are otherwise entitled.
WHAT IF YOU DECIDE NOT TO GIVE PERMISSION TO USE AND GIVE OUT YOUR INFORMATION?
By clicking Submit on this informed consent form and authorization, you are
giving permission for Us to obtain, use and share your information as described
above. If you refuse to give permission, you are declining to be in this
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Information that is already in the Registry cannot be removed, deleted or
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may be related to this Registry, Our Privacy Officer can be reached by email at
privacy@recoverycoa.com or at 484-803-9655 during business hours.
Do not click Submit on this informed consent form unless you have had a chance
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confirming that you have read the information in the “Informed Consent to
Participate in the Medical Record Registry” document and you are voluntarily
agreeing to be in the Registry.
By clicking Submit on this Authorization, you authorize any health plan,
physician, health care professional, hospital, clinic, laboratory, pharmacy,
pharmacy benefits manager, medical facility, health information exchange, health
information aggregator or other health care provider that has provided payment,
treatment or services to you to release and disclose the following records to
GENETWORx to be incorporated into the Registry:
Any and all information (including personal, health, demographic, claims,
billing, pharmacy and medical records) created in the ten years prior to the
date of this Authorization or at any time after the date of this Authorization
for as long as this Authorization remains in effect.
The records provided to the Registry will include the following highly protected
information (known as Sensitive PHI)
* Substance abuse records (including alcoholism)
* AIDS or HIV treatment records
* Mental health services (does not include psychotherapy notes)
* Genetic information
By clicking Submit on this Authorization, you authorize GENETWORx to use and
share your information in the Registry for medical, research, commercial,
marketing or other business purposes including, but not limited to, those
described in the Informed Consent.
This Authorization involves the use of a Registry and will remain in effect
until you revoke it.
You may change your mind and revoke (take back) the right to use your protected
health information at any time. However, even if you revoke this Authorization,
the Registry may still maintain, use or disclose information it has already
collected about you. If you revoke this Authorization, GENETWORx will no longer
collect new information about you for the Registry. To revoke this
Authorization, you must email privacy@recoverycoa.com.
I understand that information disclosed to the Registry pursuant to this
Authorization may be subject to re-disclosure and may no longer be protected by
federal and state law.
By clicking Submit, you are voluntarily agreeing to be in this Registry and to
the use and disclosure of your protected health information as described above.
Your health information is being released to GENETWORx at your request. You
understand that your treatment, payment, enrollment or eligibility for benefits
does not depend on whether you click Submit on this Authorization and
participate in the Registry.
To manage or change opt in preferences or revoke this Authorization, you must
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and affiliated companies may send you SMS messages using autodialing technology
from our primary messaging code 73529 for health-related information and as
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apply. Reply HELP or help, STOP to cancel. Msg freq may vary.Your consent is not
required as a condition of purchasing any product, good, or service.
INFORMED CONSENT TO PARTICIPATE IN MEDICAL RECORD REGISTRY
GENETWORx and its affiliates (“We, Us, Our”) are creating a medical record
registry to help Us predict, prevent, and treat disease (the “Registry”). The
Registry matches patients’ laboratory test information with medical history
information obtained from health plans, physicians, health care professionals,
hospitals, clinics, laboratories, pharmacies, pharmacy benefits managers, and
other medical facilities. We will use data analytics, artificial intelligence
and other automated tools to analyze the data in the Registry for various
purposes including improving Our patient care and outcomes, lowering costs,
recommending products and services to support your health and wellbeing, or
sharing data with other healthcare providers, medical researchers, drug
developers, and clinical trial teams to advance medical science.
SUMMARY OF INFORMATION
* This Informed Consent and Authorization asks for your permission to
participate in the Registry by allowing Us to obtain, store, use and share
your information.
* Participation is voluntary and will not affect your care in any way.
* We may share your de-identified information with third parties without any
further consent or authorization.
* Once collected by Us, your information will be stored with industry standard
security safeguards.
WHAT IS A REGISTRY?
A Registry is a collection of information about people who have various diseases
or conditions, or who receive various tests or treatments. The Registry holds
patient information according to the data security standards of federal and
state law.
This Informed Consent provides you with information that you should know and
understand before agreeing to add your information to the Registry. Please read
this Informed Consent carefully.
WHAT INFORMATION IS BEING COLLECTED FOR THE REGISTRY?
Information (data) will be collected from your health plans, physicians, health
care professionals, hospitals, clinics, laboratories, pharmacies, pharmacy
benefits managers, and other medical facilities. We will collect health,
demographic, claims, billing, pharmacy and medical records. All information will
be collected from your records of the care you have received in the past ten
years, are receiving or will be receiving in the future for so long as you
continue to participate in the Registry.
HOW WILL INFORMATION IN THE REGISTRY BE USED?
The purpose of this Registry is to help Us predict, prevent, and treat disease.
Information in the Registry may be used for medical, research, commercial,
marketing or other business purposes including, but not limited to providing
healthcare or care coordination services, communicating with you about
diagnostic tests, clinical trials or other healthcare related services that may
be of interest based upon your medical history including marketing and promoting
our services and the services of third parties, aggregating and analyzing data
to understand or improve Our testing, treatment services, and operations,
research to predict, prevent and treat disease(s), de-identifying data to create
data sets that will be shared with third parties such as medical researchers and
drug developers to advance medical treatment, for administrative purposes, and
for other legally permissible purposes.
HOW WILL MY HEALTH INFORMATION BE SHARED?
We may share your identifiable information with Our affiliates under common
ownership to use for the same purposes for which We may use your information. We
may also share your information with third party service providers performing
services on our behalf. We may share your information for legal purposes
including as we deem necessary to respond to a subpoena, regulation, binding
order of a data protection agency, legal process, governmental request or other
legal or regulatory process. We may also share your information in business
transfers including in connection with a merger, acquisition, the sale of
company assets, or in any similar transaction, or to the extent as may be
required in the unlikely event of insolvency bankruptcy, or a receivership. Once
your information is de-identified is no longer personal information and can be
used by Us and shared with third parties for any purposes, including sale to
third parties.
HOW LONG IS YOUR PARTICIPATION IN THE REGISTRY?
With your authorization, we will collect your historic and future health
information when you enroll in the Registry. You may stop participating in the
Registry at any time.
WHAT RISKS ARE KNOWN ABOUT BEING IN THE REGISTRY?
We will comply with the applicable HIPAA standards that protect your health and
personal information. However, there is the potential risk your participation in
this Registry may expose your information (including health information) stored
in the Registry.
There may be other risks that are not known at this time.
WHAT BENEFIT CAN YOU EXPECT?
You may receive a benefit from participation in the Registry if We are able to
provide you information about diagnostic tests or clinical studies for which you
may be eligible. For research related purposes, you will not receive any direct
benefit.
WHAT ARE THE FINANCIAL CONSIDERATIONS?
Cost
There will be no cost to you for your participation in this Registry.
Payment for Participation
You will not be paid for your participation in this Registry or for any future
use of the information in the Registry.
VOLUNTARY PARTICIPATION/WITHDRAWAL
Your decision to take part in this Registry is completely voluntary. You are
free to choose not to take part in the Registry and may change your mind and
withdraw at any time. Your relationship with Us and your care through Us (now or
in the future) will not be affected in any way if you withdraw or refuse to
participate. You will not lose any benefits to which you are otherwise entitled.
WHAT IF YOU DECIDE NOT TO GIVE PERMISSION TO USE AND GIVE OUT YOUR INFORMATION?
By clicking Submit on this informed consent form and authorization, you are
giving permission for Us to obtain, use and share your information as described
above. If you refuse to give permission, you are declining to be in this
Registry.
Information that is already in the Registry cannot be removed, deleted or
withdrawn.
QUESTIONS
If you have any additional questions, or if you wish to report a problem that
may be related to this Registry, Our Privacy Officer can be reached by email at
privacy@recoverycoa.com or at 484-803-9655 during business hours.
Do not click Submit on this informed consent form unless you have had a chance
to ask questions and have received satisfactory answers to all your questions.
AGREEMENT TO PARTICIPATE IN REGISTRY AND AUTHORIZATION
To enroll in the GENETWORx Registry, you or your legal representative must click
Submit on this Authorization. By clicking Submit on this page, you are
confirming that you have read the information in the “Informed Consent to
Participate in the Medical Record Registry” document and you are voluntarily
agreeing to be in the Registry.
By clicking Submit on this Authorization, you authorize any health plan,
physician, health care professional, hospital, clinic, laboratory, pharmacy,
pharmacy benefits manager, medical facility, health information exchange, health
information aggregator or other health care provider that has provided payment,
treatment or services to you to release and disclose the following records to
GENETWORx to be incorporated into the Registry:
Any and all information (including personal, health, demographic, claims,
billing, pharmacy and medical records) created in the ten years prior to the
date of this Authorization or at any time after the date of this Authorization
for as long as this Authorization remains in effect.
The records provided to the Registry will include the following highly protected
information (known as Sensitive PHI)
* Substance abuse records (including alcoholism)
* AIDS or HIV treatment records
* Mental health services (does not include psychotherapy notes)
* Genetic information
By clicking Submit on this Authorization, you authorize GENETWORx to use and
share your information in the Registry for medical, research, commercial,
marketing or other business purposes including, but not limited to, those
described in the Informed Consent.
This Authorization involves the use of a Registry and will remain in effect
until you revoke it.
You may change your mind and revoke (take back) the right to use your protected
health information at any time. However, even if you revoke this Authorization,
the Registry may still maintain, use or disclose information it has already
collected about you. If you revoke this Authorization, GENETWORx will no longer
collect new information about you for the Registry. To revoke this
Authorization, you must email privacy@recoverycoa.com.
I understand that information disclosed to the Registry pursuant to this
Authorization may be subject to re-disclosure and may no longer be protected by
federal and state law.
By clicking Submit, you are voluntarily agreeing to be in this Registry and to
the use and disclosure of your protected health information as described above.
Your health information is being released to GENETWORx at your request. You
understand that your treatment, payment, enrollment or eligibility for benefits
does not depend on whether you click Submit on this Authorization and
participate in the Registry.
To manage or change opt in preferences or revoke this Authorization, you must
call 844-335-2482.
Upon request, you will be given a signed copy of this Authorization form to keep
for your personal records.
If you are a human seeing this field, please leave it empty.
(866) 932-0109
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