New Patient Enrollment Form

Genetic Methylation Test Kit

Complete the following information for who the test is for and where to ship the test kit.
Name*

First NameLast Name
Date of Birth*

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Date
Sex*
Contact Number:*
E-mail*
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Address:*

Street Address

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Enter the Names, DOB, Gender of others you are ordering a test for. All Test Kits will be shipped to address on form unless otherwise noted.
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Genetic Methylation Testing Consent

By proceeding with genetic methylation testing through Drip Into Wellness, I acknowledge and understand that this test and its associated review call are intended for informational and educational purposes only. The results provided do not constitute medical diagnosis, treatment, or medical advice, and are not intended to replace care or recommendations given by my physician or healthcare provider.

I understand that Drip Into Wellness and Lauren McCrossin, RN | Founder, are not acting in the capacity of a licensed physician in providing this service. I am encouraged to consult with my primary care provider or medical specialist before making any health, lifestyle, or supplement changes based on these results.

I accept full responsibility for any choices I make following this testing and release Drip Into Wellness, Lauren McCrossin, RN, and any affiliates or representatives from any and all liability related to the interpretation or use of this genetic data.

By signing or acknowledging this consent, I confirm that I have read, understand, and agree to the terms above.
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My Products*

Methylation Testing + Review Product Image

Methylation Testing + ReviewMethylation Genetic Testing + Review Call

$350.00 Quantity

Total

$0.00

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I understand there are no refunds on the testing kit or review call.
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Genetic Methylation Test Kit

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