Client Intake Form

Section 2: Type of DNA Test Requested

(Please select the test(s) you’re interested in.)
Select Your DNA Test*

Section 4: Sample Collection Preferences

Please choose your preferred method for sample collection
How would you like the DNA samples to be collected?*

Mail-in kit (Only available for Peace-of-Mind Test)Mobile collection at my home or office (+$75 if not included)Schedule a visit to a collection siteNot sure yet — please contact me
What is your zip code or preferred collection area?*
When would you like the collection to happen?*

MonthDayYear
Date
We will contact you to confirm the final date, time, and location after reviewing your request.

Section 5: Reason for Testing

Tell us why you’re requesting this DNA test. This helps us better serve you.
Briefly explain the reason for the test. *
Example: “Court case,” “For peace of mind,” “USCIS request,” “Child support hearing,” etc.

Section 6: Results, Timeline and Delivery

Tell us when you need results and how you’d like to receive them.
Do you need expedited results?*

YesNoNot sure yet
When do you need your results by?

MonthDayYear
This is a preferred date and does not guarantee delivery, but we’ll do our best.
How would you like to receive your results?*

EmailPhone CallMailed printed copyAny of the above

Section 7: Consent and Authorization

Please review and sign to confirm your request.
By submitting this form, I confirm that I am legally authorized to request this DNA test and that all individuals being tested are providing informed consent. I understand that results will be handled confidentially and in accordance with applicable laws.

Cost Disclaimer

Legal and Immigration tests include mobile collection by default.
Peace-of-Mind and Infidelity tests may be collected by mail or with our mobile collector for an additional $75.
Final pricing will be confirmed based on your selections.
I confirm that I have read and agree to the statement above.*

Yes
Digital Signature*

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Date of Signature*

MonthDayYear
Date
Anything else we should know?
Payment Amount

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Section 1: Client Contact info