October 5, 2000

Dr. Pierluigi Gambetti, Director
National Prion Disease Pathology Surveillance Center
Institute of Pathology
Room 419, Case Western Reserve University
2085 Adelbert Road
Cleveland, OH 44106

Dear Dr. Gambetti:

I am requesting a genetic blood test for mutations in the PRNP gene.  I have enclosed a sample of my blood for that testing.

I wish to know my result.  Please forward the result to the following physician:

Physician X (include address)

Thank you for your assistance in this matter.

Sincerely,

Jane Doe

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