Preconception Genetic Screening Questionnaire
What a preconception genetic screening questionnaire asks, with sample questions for fertility clinic staff.
The preconception genetic screening questionnaire described here, from WashU Medicine and NYU Fertility Center, records each partner's ancestry, earlier genetic tests, and family history. It's also called a carrier screening questionnaire.
Preconception genetic screening questionnaire, handled by the AI Doctor avatar
AI Doctor, a real-time AI healthcare assistant avatar, asks the questions on a preconception genetic screening questionnaire in the patient's own language, strictly following the practice's instructions.
- Intake before the visit. Patients answer online before they arrive, or at a kiosk when they check in.
- Answers ready for the clinician. Clinicians see what the patient said before the visit starts.
- Less workload at the front desk. Staff spend less time handing out forms and entering answers by hand.
- Key details at a glance. The care team sees what matters up front and decides who needs attention first.
The form becomes a natural conversation: patients answer by talking, in their own words. AI Doctor is an information and patient-assistance interface. It collects answers for the care team to review. It doesn't diagnose, triage, or give treatment advice.
Sample preconception genetic screening questionnaire questions
Typical questions, written out so you can see the level of detail. Every practice words its own form differently.
- What is your ancestry or ethnic background?Ancestry
- Do you have any Ashkenazi Jewish ancestry?Ancestry
- Have you had carrier screening before?Past testing
- Have you ever had a chromosome analysis?Past testing
- Do you have a known genetic condition?Known conditions
- Are you a known carrier of a condition?Known conditions
- Have you had more than two miscarriages?Pregnancy history
- Was a past pregnancy diagnosed with a birth defect?Pregnancy history
- Are you and your partner biologically related?Relatedness
- If so, how are you related?Relatedness
- Does anyone in your family have cystic fibrosis?Family history
- Has a relative had cancer before age 50?Family history
These are examples to read, not a form to fill in.
Preconception genetic screening questionnaire: FAQ
What does a preconception genetic screening questionnaire ask?
The sample questions on this page are based on two forms: the WashU Medicine Genetic Screening Questionnaire and the NYU Fertility Center Preconception Genetic Questionnaire. This page groups them into six areas: ancestry, past testing, known conditions, pregnancy history, relatedness, and family history.
Who fills in a preconception genetic screening questionnaire?
The patient and, if there is one, the partner. Both forms ask about each partner and their families, and at WashU Medicine it is part of the new patient packet.
Why does the practice ask these questions?
The WashU form says the answers help the center see whether a patient may benefit from more testing or genetic counseling. The form also asks patients to raise any other family concerns with their physician.
Is it the same as a carrier screening questionnaire?
Partly. The questionnaire asks about carrier screening, a test, and the NYU form lists carrier tests such as cystic fibrosis and spinal muscular atrophy.
Should patients bring earlier test reports?
Yes, if they have them. Both forms ask for a copy of any earlier genetic or carrier test report.
What happens after a preconception genetic screening questionnaire?
The practice's team reviews the answers, and the avatar does not interpret them. On the NYU form, the physician then records any recommended genetic counseling or testing.
Does AI Doctor give medical advice?
No. It collects information for the care team. It doesn't diagnose, triage, or recommend treatment.
Can patient answers stay on our own servers?
Yes. RAVATAR offers on-prem deployment: the platform can run inside your own perimeter, so patient answers stay there. RAVATAR complies with GDPR and the EU AI Act.
Set up your AI Doctor in Genesis AI Avatar Studio
Genesis AI Avatar Studio is where you set up, test, and publish AI avatars for your website, mobile app, or Holobox. No coding or technical skills needed.
- 01Choose the AI Doctor avatar.
- 02Add your practice's FAQs and visit information.
- 03Talk to it, then publish it.
