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Genetic counselling for selected familial disorders

Sonic Genetics offers pre- and post-test telephone-based genetic counselling to patients having diagnostic or cascade genetic testing for selected disorders. This offer covers: 

In selected circumstances, this service is available at no charge to the patient; in other settings, a fee will be charged.

The scope of the genetic counselling is limited to the non-medical implications of the genetic test for the patient and relatives. The requesting doctor remains responsible for the continuing medical management of the patient.

We do not offer genetic counselling for testing for other familial disorders. There are other genetic counselling services in the both the private and public sectors across Australia. The contact details for these genetic counselling services are listed here.

Is genetic counselling mandatory prior to diagnostic testing?

There is no consistent national guidance regarding the need for genetic counselling prior to a diagnostic genetic test i.e. a test that is designed to a make a genetic diagnosis in an affected person. Some Australian guidelines recommend but do not mandate pre-test genetic counselling.

To provide clarity and consistency in this matter, we have a policy that is informed by the Medicare Benefits Schedule:

  • If a diagnostic genetic test (or one similar to it) is rebated and there is no restriction on the type of doctor who can order the test, we will accept requests for testing on the basis of implied consent by the patient. Sonic Genetics does not require (or offer) genetic counselling for such tests; the doctor could refer the patient to a genetic counselling service if required (see list of services here).
  • If a diagnostic genetic test (or one similar to it) is rebated and requests are limited to medical specialists and consultant physicians, we will accept requests from such specialists provided there is explicit evidence that the patient has provided informed consent. We can provide genetic counselling in this context (on request), but do not require further evidence from the requesting specialist that this has been done. A specialist can use our consent form to guide the pre-test discussion with the patient and to document consent, but this is not mandatory.
  • If a diagnostic genetic test (or one similar to it) is rebated and requests are limited to medical specialists and consultant physicians, we will only accept requests from GPs if there is explicit evidence of pre-test genetic counselling and informed consent obtained by a certified genetic counsellor. We offer genetic counselling in this context (on request), or the doctor could refer the patient to a genetic counselling service (see list of services here).

Is genetic counselling mandatory prior to cascade testing?

The situation is different regarding genetic counselling prior to a cascade genetic test i.e. testing an unaffected relative for the family’s mutation. The regulations covering laboratory practice in Australia require that laboratories confirm that appropriate pre-test genetic counselling and written informed consent has been obtained before doing a cascade test. We have interpreted this requirement as follows:

  • If a cascade test is requested by a medical specialist or consultant physician with expertise in the management of the disorder, we will accept requests from such specialists provided there is explicit evidence that the patient has provided informed consent. We can provide genetic counselling in this context (on request), but do not require further evidence from the requesting specialist that this has been done. A specialist can use our consent form to guide the pre-test discussion with the patient and to document consent, but this is not mandatory.
  • If a cascade genetic test is requested by a GP or a specialist without specific expertise in the management of the disorder, we will only accept requests if there is explicit evidence of pre-test genetic counselling and informed consent obtained by a certified genetic counsellor. We offer genetic counselling in this context (on request), or the doctor could refer the patient to a genetic counselling service (see list of services here).

Eligibility for this service

  • The patient must be referred to a Sonic pathology practice in Australia for one of the genetic tests listed above.
  • If the price of the test (as shown in the links above) is at least $1,000, pre- and post-test genetic counselling is offered at no charge to the patient. This applies to both Medicare-rebated and private tests. Please note that Medicare may limit rebated genetic testing to patients who fulfil specific clinical criteria and to requests from a medical specialist; please check the links above for details.
  • If the price of the test (as shown in the links above) is less than $1,000, pre- and post-test genetic counselling is usually offered for a fee of $180; please check with us regarding possible exceptions. This fee is not covered by Medicare or most private health insurers.

How the service works

Genetic counselling offered by Sonic Genetics is provided as a clinical service on the basis of a referral from the patient’s doctor. If a patient wishes to self-refer for genetic counselling, they could approach a genetic counselling provider directly; details of such services can be found here.

If the doctor would like to refer a patient for genetic counselling:

  1. Please indicate on the request form that genetic counselling is requested. If you are using a special purpose request form for a particular test (see test links above), there is a tick box to indicate your request. You can also write this request on a standard pathology request form.
  2. Ask the patient to present to a Sonic collection centre to provide a blood sample.
  3. The local Sonic pathology practice will contact the patient to advise if there will be a private fee for the genetic test or the genetic counselling (or both).
  4. As soon as any applicable fee is paid, the blood sample will be shipped to one of Sonic’s genetic laboratories.
  5. Sonic Genetics will arrange for a genetic counsellor to phone the patient to arrange a convenient time for a telephone consultation. The consultation takes 45-60 minutes. The genetic counsellor then send a letter to both the referring doctor and the patient regarding that consultation, and sends the completed consent form to the laboratory. 
  6. The laboratory tests the sample and provides a report to both the requesting doctor and the genetic counsellor. The genetic counsellor will usually call the patient with the result, and notify the requesting doctor (in writing) once this has happened. By prior arrangement, this contact by the genetic counsellor can be deferred until the doctor has spoken to the patient.

This service is limited to one pre-test counselling session per patient. Post-test counselling may be by letter or telephone consultation, as decided by the counsellor and patient. The scope of counselling is limited to issues directly relating to the test being provided; this is not a general genetic counselling service.

Request and consent forms