Add a new Laboratory

Please fill in this form as accurately as possible.
Use the 'Save temporarily' button to be able to finish the form at a later date. Make sure you entered a primary contact person. A unique link will be sent to the person you appoint as primary contact.
Fields marked with * are required
When everything is finished, please click the 'Submit' button. You will be asked to approve the data one last time and if you agree your data will be sent to the EuroGentest validation team. You will be contacted if further data is required for validation and if not your data will be added to the QAu database. You will be kept up to date for each step of the process by means of email.

Consent

I give my permission to EuroGentest to release this data online in the QAu database on the EUGT and Orphanet website *	Yes No
I give my permission to the EQA providers (providing schemes for molecular genetics, cytogenetics and/or biochemical genetics) to release and validate EQA participation for 2006 and 2007. Only participation and not performance will be validated. *	Yes No

EUGT ID	Only if you are in the Orphanet database. Look up your eugt id here
acronym
Full name of laboratory *
Department
Institution *
Street *
Postcode *
city *	English name if possible
Postcode postfix	Only for certain countries. Example 51092 REIMS CEDEX, CEDEX = postcode postfix
Country *
phone (secretary)
fax
website
Setting *	Private for-profit Private hospital Private non-for-profit Private sector Public Public hospital Public non-hospital based Research Other
Type of genetic activity *	Biochemical genetics Cytogenetics (Constitutional) Cytogenetics (Somatic cancer) Molecular genetics (Constitutional) Molecular genetics (Somatic cancer) PGD Postnatal Prenatal

You have to add one laboratory director, one department director. You can add one or more quality managers or others.

Please indicate which statements are true. Additional questions will appear below according to your answers.

Your lab has a Quality manager *	Yes No
Your lab is accredited or has an accreditation underway for human genetic testing *	Yes No
Your lab is licensed or has licensing underway *	Yes No
Your lab participated in EQA schemes for human genetic testing in 2006 or 2007 *	Yes No

Is your laboratory accredited? *	YesUnderway
By which accreditation body? *
By which accreditation standard? *
Since which year? *
Until which year (leave blank if ongoing)?	accreditation_state_new_1
What is your accreditation number (Number of scope)?	accreditation_state_new_1
What is the url of the most recent scope?	accreditation_state_new_1
Type of genetic activity	Biochemical genetics Cytogenetics (Constitutional) Cytogenetics (Somatic cancer) Molecular genetics (Constitutional) Molecular genetics (Somatic cancer) PGD Postnatal Prenatal

Is your laboratory accredited? *	YesUnderway
By which accreditation body? *
By which accreditation standard? *
Since which year? *
Until which year (leave blank if ongoing)?	accreditation_state_new_
What is your accreditation number (Number of scope)?	accreditation_state_new_
What is the url of the most recent scope?	accreditation_state_new_
Type of genetic activity	Biochemical genetics Cytogenetics (Constitutional) Cytogenetics (Somatic cancer) Molecular genetics (Constitutional) Molecular genetics (Somatic cancer) PGD Postnatal Prenatal

Is your laboratory licensed? *	YesUnderway
By which licensing body? *
Since which year? *
What is your licensing number?	licensing_state_new_1
Type of genetic activity	Biochemical genetics Cytogenetics (Constitutional) Cytogenetics (Somatic cancer) Molecular genetics (Constitutional) Molecular genetics (Somatic cancer) PGD Postnatal Prenatal

Is your laboratory licensed? *	YesUnderway
By which licensing body? *
Since which year? *
What is your licensing number?	licensing_state_new_
Type of genetic activity	Biochemical genetics Cytogenetics (Constitutional) Cytogenetics (Somatic cancer) Molecular genetics (Constitutional) Molecular genetics (Somatic cancer) PGD Postnatal Prenatal

Please specify your participation for 2006 and 2007 (only participation data, and not performance, are listed)

Sybmols

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EUGT number: number assigned by Orphanet to the labs in the Orphanet database and used by the EuroGentest QAu database to link the quality assurance data of the labs to their data in the Orphanet database. The aim is to use this number as a unique identifier for a lab across different databases.
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