HomeTest DNA Kit Registration ITSIBIO » HomeTest DNA Kit Registration "*" indicates required fields Step 1 of 3 - Person Registering Kit Information 33% CTS Confirmation #LSDFC Confirmation #ITSI Confirmation #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* MM slash DD slash YYYY Relationship*Alleged FatherAlleged MotherAlleged Son / DaughterAlleged Aunt / UncleAlleged Niece / NephewAlleged Grandfather / GrandmotherAlleged GrandchildDo you want to add another tested party? Yes No Tested Party 2 InformationName* First Last Gender*MaleFemaleDate of Birth* MM slash DD slash YYYY Relationship*Alleged FatherAlleged MotherAlleged Son / DaughterAlleged Aunt / UncleAlleged Niece / NephewAlleged Grandfather / GrandmotherAlleged GrandchildDo you want to add another tested party?* Yes No Tested Party 3 InformationName* First Last Gender*MaleFemaleDate of Birth* MM slash DD slash YYYY Relationship*Alleged FatherAlleged MotherAlleged Son / DaughterAlleged Aunt / UncleAlleged Niece / NephewAlleged Grandfather / GrandmotherAlleged Grandchild Kit InformationEnter the Barcode No. on Your Kit:Where did you purchase your kit?* ITSIBIO (US) - Online LSD&FC (Lagos) - In Person or Online CTS (Abuja) - In Person or Online Other Kit Purchase Location* Name of Pharmacy/Store/Hospital Address City State This field is hidden when viewing the formPerson Authorized To Receive The Result: Tick and skip if same as person registering kit. This field is hidden when viewing the formAuthorized Recipient First Name Last Name This field is hidden when viewing the formEmail This field is hidden when viewing the formPhoneConsent* I understand that the kit will not be processed until the laboratory fee is paid.*CommentsThis field is for validation purposes and should be left unchanged.
