Transgenomic Molecular Laboratory

DNA Specimen Collection Kit Request

To order DNA Specimen Collection Kits, provide the information below and the kit(s) will be sent to you free of charge.

Transgenomic Molecular Laboratory provides DNA Specimen Collection Kits for your convenience equipped with all materials required for safe collection and transportation in compliance with federal and IATA shipping instruction 650.

Always check the specific test requirements in the test catalog when ordering DNA Specimen Collection Kits.

For specific questions or special specimen requests, contact your regional representative
or contact Client Services at 1 (866) 500-GENE (4363).

All kits come complete with:

Appropriate vacutainer tubes for each test
Bubble wrap, padding and specimen bag
Test Requisition Form
Patient Consent Form
Specimen Submission Checklist
Shipping labels and prepaid air bill
Large shipping Clinical Pak

DNA Specimen Collection Kit Request Form

* Required Fields

	Name*
	Company/Institution*
	Position
	Phone *
	FAX
	E-mail *
	Address *
	Address
	City *
	State/Province *
	Zip/Postal Code *
	Country *
	Number of DNA Specimen Collection Kits-Catalog No. 443002


Additional Questions or Comments: