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First Name
Last Name
Firm Name
E-mail
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example@example.com
Confirm Email
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example@example.com
Phone number
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Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What Kind of Testing?
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DNA Testing (Legal)
DNA Testing (Immigration)
Drug Testing
Alcohol Testing
Drug and Alcohol Testing
Instructing party Case Reference
Case Type
Care proceedings/Public Law
Private Law
Private Instruction
Other
Court Ref:
Court filing/Deadline Date
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Month
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Day
Year
Date
PO number (if required):
Would you like us to proceed immediately or requesting a quote to approve?
Proceed straight to testing
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DNA Testing Details
DNA Testing Type
Please Select
Paternity/Maternity testing
Sibling Testing
Complex Testing
Total number of people to test
Please Select
1 person
2 people
3 people
4 people
Please detail what you are trying to prove. eg. Establish whether the siblings are full or half siblings.
Participants details
Main Participant
Main Participants Name
First Name
Last Name
Main Participants Date of Birth
-
Month
-
Day
Year
Date
Main Participants Email
example@example.com
Phone number
Main Participants Relationship
Please Select
Alleged Father
Mother
Son
Daughter
Aunt
Uncle
Niece
Nephew
Grandmother
Grandfather
Other
2nd Participants Details
2nd Participants Name
First Name
Last Name
2nd Participants Date of Birth
-
Month
-
Day
Year
Date
2nd Participants Contact number
2nd Participants Email
example@example.com
2nd Participants Relationship
Please Select
Alleged Father
Mother
Son
Daughter
Aunt
Uncle
Niece
Nephew
Grandmother
Grandfather
Other
3rd Participants Details
3rd Participants Name
First Name
Last Name
3rd Participants Date of Birth
-
Month
-
Day
Year
Date
3rd Participants Contact number
3rd Participants Email
example@example.com
3rd Participants Relationship
Please Select
Alleged Father
Mother
Son
Daughter
Aunt
Uncle
Niece
Nephew
Grandmother
Grandfather
Other
4th Participants Details
4th Participants Name
First Name
Last Name
4th Participants Date of Birth
-
Month
-
Day
Year
Date
4th Participants Contact number
4th Participants Email
example@example.com
4th Participants Relationship
Please Select
Alleged Father
Mother
Son
Daughter
Aunt
Uncle
Niece
Nephew
Grandmother
Grandfather
Other
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Drug Testing
Matrix sample
Head Hair
Body Hair
Fingernail
Toenail
Please be aware body hair analysis is only an overview detection period. Approximately 0-4 and up to 8 months.
Please be aware fingernail analysis is only an overview detection period. Approximately 0-3 and up to 6 months.
Please be aware toenail analysis is only an overview detection period. Approximately 0-6 and up to 12 months.
Detection period required
Please Select
1 month (1cm)
2 months (2cm)
3 months (3cm)
4 months (4cm)
5 months (5cm)
6 months (6cm)
7 months (7cm)
8 months (8cm)
9 months (9cm)
10 months (10cm)
11 months (11cm)
12 months (12cm)
Segmented or overview analysis?
Please Select
Overview (3 months maximum)
Segmented (month by month)
Bi-Monthly analysis
Specific Drugs
Amphetamine
Benzodiazepines
Cannabis
Cocaine (inc crack cocaine)
Ketamine
LSD
Mephedrone
Methadone
Methamphetamines (ecstasy, MDMA)
Opiates (inc heroin)
Tramadol
Spice (Synthetic cannabinoids)
Steroids
Other
If other please state
History of drug use
Please detail what you are looking to establish.
Do you also require alcohol testing
Yes
No
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Alcohol Testing
Type of alcohol testing
Please Select
Excessive alcohol abuse
Abstinence
Has the participant had a history of alcohol abuse?
Please Select
Yes
No
Abstinent since
-
Month
-
Day
Year
Date
Blood alcohol testing
Phosphatidylethanol (PEth)
Carbohydrate Deficient Transferrin (CDT)
Liver Function Test (inc Gamma GT)
Full Blood Count (inc MCV)
Matrix Sample
Head Hair (EtG/EtPa)
Body Hair (EtG)
Fingernail (EtG)
Toenail (EtG)
Detection period
0-3 months (3cm)
0-6 months (6cm)
Other
If other please state
Please be aware it is not possible to segment alcohol hair strand testing.
Please be aware body hair analysis is only an overview detection period and can only test for EtG. Approximately 0-4 and up to 8 months.
Please be aware fingernail analysis is only an overview detection period and can only test for EtG. Approximately 0-3 and up to 6 months.
Please be aware toenail analysis is only an overview detection period and can only test for EtG. Approximately 0-6 and up to 12 months.
What are you looking to establish?
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Participants Details
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Number
Preferred location for sample collection
Please Select
Participants home address
Solicitors Office
Other
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Additional Parties
Split Invoicing required?
Please Select
Not Required
1 Additional Party (2 Total)
2 Additional Party (3 Total)
3 Additional Party (4 Total)
4 Additional Party (5 Total)
Additional Party: Number 1
Name
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First Name
Last Name
Email
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example@example.com
Contact number
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Firm name
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Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Client representing
PO number (if required)
Additional Party: Number 2
Name
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First Name
Last Name
Email
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example@example.com
Contact number
*
Firm name
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Client representing
Additional Party: Number 3
Name
*
First Name
Last Name
Email
*
example@example.com
Contact number
*
Firm name
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Client representing
Additional Party: Number 4
Name
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First Name
Last Name
Email
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example@example.com
Contact number
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Firm name
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Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Client representing
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