Variant Reclassification Addendum Note

Addendum Date/Time: [date and time authored]

Author: [name, credentials, role]

Patient: [identifiers per institutional standard]

Original Report Reference: [original genetics note date and lab report date/accession number] (If original report not found in EHR, state: "Original report not found in EHR—request initiated on [date].")

[Opening statement that this is an addendum documenting a genetic variant reclassification and updated clinical implications] (Specify trigger: lab-issued amended/updated report or clinician-initiated reinterpretation. If clinician-initiated, explicitly state this does not replace a laboratory-issued amended report unless the laboratory reissues.)

Reason for Addendum

[Trigger and rationale for addendum] (3–5 sentences. Identify trigger: lab-issued amended/updated report received on [date], lab notification of reclassification, or clinician-initiated reinterpretation with rationale. Clearly state the change at a high level: variant classification changed from [prior classification] to [new classification]. Include source details: laboratory name, report type, report date, accession/case ID, and where the report is stored in the EHR.)

Reclassification Summary

(Present as concise row(s). Add additional rows if multiple variants.)

• Variant | Original Classification (date) | New Classification (date) | Direction
• [gene; HGVS nomenclature with transcript ID and version; zygosity] | [original classification] ([date]) | [new classification] ([date]) | [upgrade / downgrade]

[One-sentence statement on whether this reclassification changes the patient's diagnosis and/or management recommendations] (If either the new or prior classification is VUS, include: "A VUS should not be used in clinical decision-making.")

Updated Interpretation & Implications

[Brief statement on whether the new classification explains the patient's indication for testing: fully / partially / does not / uncertain]

• Diagnosis: [current diagnostic status and any changes]
• Management: [implications for surveillance, interventions, referrals] (Note any additions, revisions, or discontinuations.)
• Cascade Testing: [recommendations for relatives] (Include who to test and test type, if applicable.)
• Alternative Etiologies: [alternative causes to consider if reclassification removes prior explanation] (Omit if not applicable.)
• Prior Actions: [whether prior management based on old classification is now revised] (Omit if no prior actions were taken.)

Plan

1. [Management recommendation] — [responsible party] — [timeline]
2. [Genetic counseling follow-up] — [responsible party] — [timeline]
3. [Family communication/cascade testing steps] — [responsible party] — [timeline]
4. [Documentation tasks: problem list update, amended report upload] — [responsible party] — [timeline]
5. [Recontact genetics timeframe or triggers for re-evaluation] — [responsible party] — [timeline]

(Include only applicable items. If no changes to recommendations, state: "No change to prior management recommendations; continue prior plan.")

Recontact Documentation

(Include this section only if recontact was attempted or is planned. Never state that the patient was notified unless direct contact occurred and is documented here.)

• Attempt 1: [date/time] — [method: phone / portal / mail] — [recipient: patient / guardian / clinician] — [outcome]
• Attempt 2: [date/time] — [method] — [recipient] — [outcome] (Add rows as needed.)
• Successful Contact: [summary of what was explained, patient response, and decisions made] (Include only if contact achieved.)
• If Unable to Reach: [contact info used; next steps per policy; timeframe for additional attempts]

Signature: [author name, credentials] — [date/time signed]