Client Information & Consent Form

Client Information & Consent Form
Customer Details:
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

DNA Testing
Type of DNA Test: Each test includes 2 people unless otherwise noted.*
Select DNA Test Subtype*
Purpose of Test*
DNA Results
Result Delivery*
Preferred Appointment Date: Please select a Saturday or Sunday appointment. Weekday appointments will be considered upon request.*

MonthDayYear
Date
Preferred Appointment Time: Sat. 2-5 p.m. or Sunday 9-5p.m. Please email us about a time during the week.*

Hour Minutes

AM/PM Option
Appointment
Preferred Meeting Location: ex: Walmart parking lot in Columbus*

Individuals to be Tested
How many individuals will be tested?*
Please Note:
- Each DNA test covers a specific number of individuals, usually 2 or 3, depending on the test type.
- Only the Grandparentage test including both grandparents, the mother, and the child covers 4 individuals, and its price reflects this.
- For tests that allow extra people, you may add individuals up to a total of 4 people per test.
- An additional fee of $100 per extra person applies for any individuals added beyond the base number, up to the 4-person limit.
- Tests cannot include more than 4 individuals. If more than 4 people require testing, separate tests must be ordered.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Relationship to Parties being Tested*
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Relationship to Parties being Tested*
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Relationship to Parties being Tested*
Minor Consent (If Applicable)
Is the tested individual a minor (under 18 years old)?*
Parent/Legal Guardian*
Parent/Legal Guardian Phone Number*
Please enter a valid phone number.
Parent/Legal Guardian Email*
example@example.com
Relationship to Minor*
Do you, as parent/legal guardian, consent to the DNA testing of the minor under your care?*

Health & Consent Questions (Required):
Are all parties being tested feeling well?*
Any recent mouth surgeries or injuries?*
Any issues that could affect the buccal swab?*
Have any tested individuals had a blood transfusion in the last 30 days?*
Do you consent to legal DNA testing with chain-of-custody procedures?*
Do you agree to provide valid photo ID at appointment?*
Do you understand payment is due at the time of booking the appointment?*
Do you agree to our cancellation policy (48 hours notice for full refund)?*

Acknowledgements
By signing this form, I acknowledge and agree to the following:

Voluntary Participation:
I am voluntarily consenting to DNA testing and understand that participation is not required by law unless ordered by a court.

Purpose of Testing:
I understand this test is being conducted to determine biological relationships and is not intended to diagnose medical or genetic conditions.

Accuracy and Limitations:
I understand that while DNA testing is highly accurate, no test can provide 100% certainty in all cases, and results may be inconclusive in rare situations.

Confidentiality:
All DNA samples and results will be handled confidentially, in compliance with HIPAA regulations (if applicable). Results will only be shared with those whom I authorize.

Sample Collection:
I agree to provide a buccal (cheek) swab sample for DNA testing. I will cooperate during the sample collection process.

Test Processing:
I understand that the samples will be sent to a certified laboratory for analysis, and I authorize the laboratory to perform the necessary testing.

Payment Responsibility:
I acknowledge the total cost of the selected service and have agreed to pay any fees due. I understand results will not be released until full payment is received.

Legal Use:
I understand that if this test is intended for legal use, proper identification and chain-of-custody procedures must be followed during collection.

Right to Withdraw:
I understand that I may withdraw my consent at any time before sample collection. Once testing has started, fees are not be refundable.

Swift DNA Client Liability Waiver and Release of Claims
By signing this waiver, I understand and acknowledge that:
• I am voluntarily participating in DNA sample collection services provided by Swift DNA.
• I understand that Swift DNA is a mobile collection agency and not a laboratory or legal authority.
• I understand that Swift DNA is not responsible for test outcomes, legal decisions, or how results are used after delivery.
• I release Swift DNA and its representatives from all claims, liabilities, or damages arising from my participation in this service.
• I understand that test results may be shared with the designated parties as listed in my client intake or consent form.

I confirm that I have read, understand, and agree to the terms of this waiver.
Privacy & Accessibility Notice
I acknowledge that I have been provided access to Swift DNA’s Privacy Policy and Accessibility Statement, which explains how my information is used, stored, and how the service remains accessible to all individuals.

Signature*

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Date*

MonthDayYear
Date
My Products
prevnext( X )
Duo Paternity TestingUsed to confirm the biological relationship between a child and an alleged mother, often for adoption or legal records. Establishes the biological relationship between a child and an alleged father. Admissible in court for child support, custody, and legal purposes.
$350.00 Quantity



Duo Maternity TestingConfirms a biological relationship between a child and an alleged mother, often used in adoption or immigration cases.
$350.00 Quantity



Trio TestingInvolves the child, alleged father, and mother. Improves accuracy in legalor disputed paternity cases.
$350.00 Quantity



Siblingship TestingEstablisheswhether two individuals share one or both biological parents. Helpful when thealleged parent is unavailable.
$350.00 Quantity



Grandparentage Testing - 3 peopleDetermines parentage indirectly by testing one or both grandparents and the child.
$350.00 Quantity



Grandparentage Testing - 4 peopleDetermines parentage indirectly by testing both grandparents, the mother, and the child.
$400.00 Quantity



Avuncular - TestingConfirms a biological relationship by comparing a child’s DNA to that of anaunt or uncle when the parent is unavailable.
$350.00 Quantity



Immigration - DNA TestingFor Immigration cases, we refer all immigration collections directly to trusted, AABB-accredited laboratory partners who specialize in these services to ensure compliance and court-admissible results.
$ Free Quantity



Additional Person (Extra Participant)Add a second child, parent, sibling, grandparent, aunt or uncle to the same legal DNA test case.
$100.00 Quantity



Total

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Should be Empty:

Client Information & Consent Form

DNA Testing

DNA Results

Individuals to be Tested

Minor Consent (If Applicable)

Health & Consent Questions (Required):

Acknowledgements

Swift DNA Client Liability Waiver and Release of Claims

Privacy & Accessibility Notice