Home Paternity Testing Kit Order Form

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Step 1 of 4

How many people testing*

Number of people that will be providing a sample.

Number of Shipping Addresses*

Shipping Options*

Number of Shipping Addresses*

Shipping Options*

Number of Shipping Addresses*

Shipping Options*

A $6.00 handling fee is added for standard shipping to any additional address.

Coupon

Total

Shipping Name*

First Last

Shipping Address*

Street Address Apt/Ste City State ZIP Code

Shipping Name #2*

First Last

Shipping Address #2*

Street Address Apt/Ste City State ZIP Code

Shipping Name #3*

First Last

Shipping Address #3*

Street Address Apt/Ste City State ZIP Code

Participant #1

Name*

First Last

Testing As*

Date of Birth*

Shipping Address*

Participant #2

Name*

First Last

Testing As*

Date of Birth*

Shipping Address*

Participant #3

Name*

First Last

Testing As*

Date of Birth*

Shipping Address*

Participant #4

Name*

First Last

Testing As*

Date of Birth*

Shipping Address*

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