DNA Test Order Form (5) Updated Order Form "*" indicates required fields 1Contact Info2Select a Test Requester's First and Last Name*Email* PhoneAlternate Contact (Optional)EmailPhoneContact Abroad (If Applicable) >18 years oldPhone NumberSelect a Legal/Immigration DNA Test*CLICK HERE TO SELECT A TESTPaternity Trio–US Legal- 375Parentage–All in USA – $375Parentage–International – $575Sibling–All in USA – $550Sibling–International – $750Grandparentage–All in USA – $550Grandparentage–International – $750Avuncular/Materteral (Uncle/Aunt)–All in USA- $550Avuncular/Materteral (Uncle/Aunt)–International – $750Test Participants*Test Participant 1RoleCity & CountryCase #Date of BirthTest Participants*Test Participant 2RoleCity & CountryCase #Date of BirthAdd additional Test Participants (If Applicable)3 Test Participants – $1754 Test Participants -$3505 Test Participants $350Additional Test ParticipantsAdditional Test ParticipantsRoleCity & CountryCase #Date of Birth Add RemoveMulti-File Upload (Multiple PDFs)Upload letter(s) that are requesting the DNA Test. Allowed file extension: pdf Drop files here or Select files Accepted file types: pdf, Max. file size: 300 MB. A) Requesting AgencySelect the Officially-Interested Third-Party requesting the DNA Test. USCIS US Embassy/Consulate Abroad Passport Agency Court Other ReportingAuthorized to receive reports, in addition to requester and as indicated letter requesting the DNA TestNotesPlease Post below any other comments, you want us to know: 1. All communication regarding this case will only take part with the Requester/Petitioner of this test at the phone numbers and email address provided. IntelliGenetics will notify the requester/petitioner of the sample collection appointment(s) for the individuals to be tested. NEW YORK RESIDENTS: For residents of the state of New York, IntelliGenetics must receive a copy of an Officially Interested Third Party Request (e.g. letter from an US Government Agency (USCIS, US Embassy, US Passport Agency, IRS, etc), Court-Order, Attorney’s letter, Physician’s Order), before the lab may begin processing your DNA test results. 2. If at least one Test Participant is living abroad: Select a DNA Test that is labelled “International”. The DNA collection will be scheduled at a US Embassy/Consulate only for pending USCIS and US passport, CRBA, or immigrant visa cases. ii) If all tested parties are in the US, select a DNA Test that is labelled “All in USA”. 3.”ROLE”–e.g. Mother, Father, Son, Daughter, Grandparent, Aunt, Uncle, etc. “CASE #”–This is your number in the official letter that is requesting the DNA test. If not available, then, indicate the case type or N/A. A) Order summary Parentage–InternationalThe cost is based on a flat-fee pricing structure. This fee covers the DNA analysis for 2 people, all standard shipping, administrative costs and specimen collection in the USA. US Embassy’s collection fee (or any International collection fee) is not included and must be paid directly to the collector at the point of collection. Price: Parentage–All in USAThe cost is based on a flat-fee pricing structure. This fee covers the DNA analysis for 2 people, all standard shipping, administrative costs and specimen collection in the USA. Price: Sibling–InternationalThe cost is based on a flat-fee pricing structure. This fee covers the DNA analysis for 2 people, all standard shipping, administrative costs and specimen collection in the USA. US Embassy’s collection fee (or any International collection fee) is not included and must be paid directly to the collector at the point of collection. Price: Sibling–All in USAThe cost is based on a flat-fee pricing structure. This fee covers the DNA analysis for 2 people, all standard shipping, administrative costs and specimen collection in the USA. Price: Grandparentage–InternationalThe cost is based on a flat-fee pricing structure. This fee covers the DNA analysis for 2 people, all standard shipping, administrative costs and specimen collection in the USA. US Embassy’s collection fee (or any International collection fee) is not included and must be paid directly to the collector at the point of collection. Price: Grandparentage–All in USAThe cost is based on a flat-fee pricing structure. This fee covers the DNA analysis for 2 people, all standard shipping, administrative costs and specimen collection in the USA. Price: Avuncular/Materteral(Uncle/Aunt)–InternationalThe cost is based on a flat-fee pricing structure. This fee covers the DNA analysis for 2 people, all standard shipping, administrative costs and specimen collection in the USA. US Embassy’s collection fee (or any International collection fee) is not included and must be paid directly to the collector at the point of collection. Price: Avuncular/Materteral(Uncle/Aunt)–All in USAThe cost is based on a flat-fee pricing structure. This fee covers the DNA analysis for 2 people, all standard shipping, administrative costs and specimen collection in the USA. Price: Additional Participants–Each QuantityThe cost is based on a flat-fee pricing structure. This fee covers the DNA analysis for additional participant Such as 2nd child, 2nd parent, 3rd sibling. Notice that Paternity trio, Sibling, Grandparentage, Avuncular and Materteral cases include Mother testing for free. Enter number of additional participants. Price: $175.00 Quantity Paternity Trio–U.S. Legal OnlyThe cost is based on a flat-fee pricing structure. This fee covers the DNA analysis for Father, 1 Child and Mother, all standard shipping, administrative costs and specimen collection in the USA. Price: B) Optional services Add Additional International Collection Site test QuantityFor International DNA collection services (e.g. at two US Embassies/Consulates): The prices listed above assumes that all parties living abroad are going to have their sample collected during the same appointment. When collected separately (e.g. at a different day or at a different location), an additional fee applies to cover the cost incurred of collecting them separately. The additional fee is $125.00 per additional location or per separate appointment. Price: $125.00 Quantity Add Additional Test Reports Quantity QuantityThe report to the Requesting Agency is included in the cost of your test. A hard copy to the Petitioner/Requester is also included when requested and after confirmation of the mailing address. But you can order additional copies of the report for $15.00 a piece. Price: $25.00 Quantity Select Processing TimeThe standard turnaround time for the lab testing process is 1-3 business days. Day 1 is the day after receipt of the final sample(s) to be tested. Cases involving kinship studies may require additional time to complete. Expedited services for same-day results and release of the reports are available only on Parentage DNA Tests for an additional fee of $360.00. Overnight shipping options for domestic delivery only are also available.Standard Processing ($0.00)Overnight Shipping of the Report–Domestic next day delivery only (+$50.00)Overnight Shipping of the DNA Kit–Domestic next day delivery only (+$50.00)Same-Day Results Expedited Testing (+$360.00) C) Secure Checkout options Pay in Full or Deposit* Pay in Full Pay Deposit of $300.00 Proceed to “CHECKOUT” to submit this form to IntelliGenetics. This field is hidden when viewing the formPay in FullCard processing system SQUARE is used to complete your transaction. Two payment options are available: i) Credit or ii) Debit card.This field is hidden when viewing the formPay Deposit of $300.00*You will be re-directed to Square to complete your transaction.Order Total: Proceed to “CHECKOUT” to submit this form to IntelliGenetics. You will be re-directed to Square for secure online payment.Secure Card Payment to IntelliGeneticsPayment to IntelliGeneticsEnter credit/debit card information, then, proceed to “CHECKOUT” to submit this form and the payment to IntelliGenetics.Feed Required: To use the Square field, please create a Square feed for this form.
