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BACKGROUND: Scaling access to preventive genetics services requires implementation of new service delivery models. We launched and evaluated a new virtual clinical service, the Preventive Genetic Counseling Service (PGCS), to support the genetic counseling needs of a network of adult primary care practices.OBJECTIVE: To determine the acceptability of a new virtual genetic counseling service to referring primary care clinicians and patients.DESIGN: A mixed-methods evaluation of the first year of clinical service operations.SUBJECTS: Referring primary care providers to and patients seen by the preventive genetic counseling service from July 2023 through June 2024.APPROACH: Mixed-methods analyses were used to synthesize quantitative findings from a clinical patient tracking system and patient surveys, as well as rapid qualitative analysis of multi-referring clinician interviews.KEY RESULTS: Of 281 patients referred in the first year, 251 were seen. The most common visit reasons were for genetic counseling regarding predisposition to breast and related cancers (203/251, 82%), preconception counseling (31/251, 12%), and lastly for interpretation of direct-to-consumer genetic testing or other (17/251, 7%). Most patients seen completed genetic testing (152/251). Most patients returned to the care of their primary care clinician without the need for specialty care follow-up after their visit (187/251, 74%). Patients who completed an after-visit survey (n = 73 of 202 invited, response rate 36%) reported high satisfaction with the service, as indicated by a net promoter score of 80. Interviews were completed with 10 clinicians who referred multiple patients. They emphasized their satisfaction with the clinical service, the importance of supporting primary care clinicians in genetics, and the value of communication and clear handoffs between this service and primary care.CONCLUSIONS: In its first year of operations, the PGCS model was acceptable to referring clinicians and patients.