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TRUE LIFE

MEDICAL

True Life Medical DNA Questionnaire

Date

Month

Day

Year

First name

Last name

Phone

Preferred Appointment date and time

Testing Location Preference

Home

Work

Other

What is the primary reason for DNA test? (Check all that apply)

Paternity Testing

Relationship Testing (siblings, grandparents)

Immigration Requirements

Health/Genetic Information

Other (please specify)

Do you require results for legal purposes or personal information only?

Legal

Personal

How would you like to receive your results?

Secure Email

Phone Call

Physical Mail

Other (please specify)

*Who should have access to the test results? (Specify names if applicable)

Are there specific confidentiality concerns we should be aware of?

Yes (please specify)

Have you had DNA testing before?

Yes

Do you have any questions or concerns about the testing process?

Yes (please specify)

How did you hear bout our mobile DNA testing services?

Do you consent to provide the necessary biological sample for DNA testing?

Yes

I understand and agree that my personal and testing information will be handled in compliance with privacy laws and company policies.

Yes

Are there any domestic concerns we should be aware of ?

Yes

DNA Testing Questionnaire

Let’s Work Together

Get in touch so we can start working together.

First Name

Last Name

Message

Thanks for submitting!

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