HomeTest DNA Kit Registration ITSIBIO » HomeTest DNA Kit Registration "*" indicates required fields NameThis field is for validation purposes and should be left unchanged.Person Registering KitName* First Last Email* Phone*This field is hidden when viewing the formHow many tested parties do you have?Tested Party InformationName* First Last Gender*MaleFemaleDate of Birth* Relationship*Do you want to add another tested party? Yes No Tested Party 2 InformationName* First Last Gender*MaleFemaleDate of Birth* Relationship*Do you want to add another tested party?* Yes No Tested Party 3 InformationName* First Last Gender*MaleFemaleDate of Birth* Relationship*Kit InformationBarcode No. of KitWhere did you purchase your kit?* Online LSD&FC (Lagos) CTS (Abuja) Other Kit Purchase Location* Name of Pharmacy/Store/Hospital Address City State Person Authorized To Receive The Result: Tick and skip if same as person registering kit. Authorized Recipient First Name Last Name Email PhoneConsent* I understand that the kit will not be processed until the laboratory fee is paid.*
