Toll Free 1-800-914-1002

PLEASE, MAKE SURE YOU FILL THE REQUIRED CORRESPONDING INFORMATION FOR ALL TEST PARTICIPANTS.

PLEASE PRESS THE SUBMIT BUTTON ON THE PREVIEW PAGE TO ENSURE DELIVERY OF YOUR ORDER FORM.

INSTRUCTIONS

If the contact person is also one of the test participants, please repeat that person's information as a participant and label his or her relationship to the case properly.

You can upload the scanned DNA Request Document you received from the U. S. Embassy or USCIS as a pdf or jpeg file up to 5MB.

If for any reason you won't be able to successfully submit this form, please contact us at info@universalgenetics.com.

 

Today's Date (MM/DD/YYYY):
*Test Type:
Number of Test Participants:
Country( Non-U.S. ) Involved in This Case:
Is There a Contact Person or lawyer involved in This Case? (Yes/No)
Contact Person or Lawyer's Information
*First Name:
*Last Name:
Address 1:
Address 2:
City:
State/Province:
Zip Code:
Country:
*Phone Number:
Email:
 
Tested Parties Information
(To add more tested parties, please click on the Add Tested Party button.)
 
*First Name:
*Last Name:
*Relationship:
Gender:
*Date of Birth:
Address 1:
Address 2:
City:
State/Province:
Zip Code:
*Country of Residence:
Email:
*Phone Number:
Additional Phone Number:
Additional Comments:
604 E. Huntington Drive, Los Angeles, CA 91016
Toll Free 1-800-914-1002
Universal Genetics LLC © 2009 | All Rights Reserved.