Submit an order form via fax

If you have questions about submitting an order, we are here to help. You can call or email FoundationNavigate to speak with a Client Services Manager at 1-888-650-4835 or FoundationNavigate@PatientAssistance.ca, Monday – Friday: 8 AM - 8 PM ET.

To be connected with a local representative about the Foundation Medicine services, please reach out to us at canada.fmi@roche.com.

ORDERING OVERVIEW

TO ORDER A Foundation Medicine TEST FOR A PATIENT

  1. Download and complete the Test Requisition Form. When applicable, include the contact information for the pathologist and institution where Foundation Medicine can retrieve the patient’s tumour specimen for analysis.
  2. Fax the requisition form, along with the pathology report and insurance information, to 617.418.2290.

TO ORDER A SPECIMEN KIT FOR A FOUNDATION MEDICINE TEST

Please contact a Client Services Manager at Foundation Navigate at 1-888-650-4835 or FoundationNavigate@PatientAssistance.ca.

Provide your contact name, phone number and/or email address, and full mailing address for the shipment. The available specimen kit types are:

  • FoundationOne CDx FFPE Specimen Kit (also used for PD-L1 IHC testing)
  • FoundationOne Liquid CDx Specimen Kit*
  • FoundationOne Heme FFPE Specimen Kit
  • FoundationOne Heme Peripheral Blood/Bone Marrow Aspirate Specimen Kit*

* If you do not have the capabilities to perform the blood collection, reach out to Bayshore to access blood draw service.

FoundationOne®CDx

Patients with solid tumours can be tested with FoundationOne CDx with an FFPE tissue sample. When submitting specimens to Foundation Medicine, please include the following items in the FoundationOne CDx Specimen Kit:

  • Appropriate specimen per FoundationOne CDx Specimen Collection Instructions labeled with two patient-specific identifiers
  • Completed Test Requisition Form
  • Copy of recent pathology/cytology reports

FoundationOne®Heme

Patients with hematologic malignancies and sarcomas can be tested with FoundationOne Heme, which is performed on FFPE, peripheral whole blood or bone marrow aspirate specimens. When submitting specimens to Foundation Medicine, please include the following items in the FoundationOne Heme Specimen Kit:

  • Appropriate specimen per FoundationOne Heme Specimen Collection Instructions, labeled with two patient-specific identifiers
  • Completed Test Requisition Form
  • Copy of recent pathology/cytology reports

Note for Bone Samples: Do not use strong acids to decalcify. Hydrochloric acid should be avoided; EDTA is recommended, and formic acid has mixed results. Place sample in decalcifying solution for minimal amount of time. Using a weaker acid and shorter time for decalcifying preserves the nucleic acid and increases likelihood for getting results on bone samples.

FoundationOne®Liquid CDx

Patients with solid tumors can be tested using our liquid biopsy, FoundationOne Liquid CDx, which requires two tubes of peripheral whole blood. When submitting specimens to Foundation Medicine, please include the following items in the FoundationOne Liquid Specimen Kit:

  • Appropriate specimen per FoundationOne Liquid CDx Specimen Collection Instructions (use only blood tubes provided in the kit
  • Completed Test Requisition Form
  • Available reports