DNA Testing Intake Form

DNA Testing Intake Form
Todays Date

MonthDayYear
Date
Name of Person Requesting Test

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Type of Test You're Requesting?

PaternityGrandparentageSiblingshipAvuncular (Aunt/Uncle)Twin TestingDeceasedNIPP- 8wks - birth (Non-Invasive Prenatal paternity Test
Please Choose One

Legal Paternity Test (Court Use)Peace of Mind - Non Legal DNA Test (Cannot Be Used For Court)
Who Will Be Tested Today?

MomChildFatherAlleged FatherGrand MotherAlleged MomGrand FatherAuntUncleAlleged SiblingOther
By signing this here I agree and understand that we have a NO REFUND policy. All services are final. You also understand that we are just the collection site, and all results come from an accredited AABB lab. Williams Collection does not guarantee any specific result, and all results are released by email. Lastly, you understand and have been made aware that there are two kinds of test. A Legal Test which CAN be used in the court of law and the Non Legal Peace of Mind Test that CANNOT be used for court.

Powered by Jotform SignClear
Appointment
Mother's Name

First Name, MILast Name
Headshot picture
Email For Results
example@example.com
Date of Birth

MonthDayYear
Date
Gender

MaleFemale
Race

Caucasian (White)African American (Black)Puerto RicanAsianAmerican IndianMixed (2 or more races)Other
Mom Signature

Powered by Jotform SignClear
Childs Name

First Name, MILast Name
Headshot Photo
Email for Results (18 & over)
example@example.com
Date of Birth

MonthDayYear
Date
Gender

MaleFemale
Race

Caucasian (White)African American (Black)Puerto RicanAsianAmerican IndianMixed (2 or more races)Other
Date

YearMonthDay
Date
If under 18 legal guardian must sign for child

Powered by Jotform SignClear
Alleged Father's Name

First Name, MILast Name
Headshot Photo
Email for Test Results (if applicable)
example@example.com
Date of Birth

MonthDayYear
Date
Gender

MaleFemale
Race

Caucasian (White)African American (Black)Puerto RicanAsianAmerican IndianMixed (2 or more races)Other
Alleged Father (if applicable)

Powered by Jotform SignClear
Additional Person Tested Name

First NameLast Name
Headshot Photo
Email for Results
example@example.com
Date of Birth

MonthDayYear
Date
Gender

MaleFemale
Race

Caucasian (White)Puerto RicanAmerican IndianAfrican American (black)AsianMixed (2 or more races)Other
Additional Person Signature

Powered by Jotform SignClear

Each person 18 and older must provide a government ID. Please upload ID for each person such as Drivers Lic, Military ID, Passport, or ID below. If you don't have access to a donors ID I will collect it at the appointment.
Mother / Alleged Mother ID
Adult Child ID
Father / Alleged Father ID
Additional Person Test ID
Should be Empty: