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Prenatal Paternity Test Registration

For Self-Collection

Please use this form to register your Prenatal Paternity Test if you plan to obtain blood collection from your own provider trained in venipuncture collection (phlebotomist, physician, etc).

Contact Name*
This name will NOT appear on the test results for confidentiality reasons. This will only be used for order and sample tracking purposes.
12-digit code consisting numbers and letters displayed on your test kit.
Passwords are case-sensitive.
This field is for validation purposes and should be left unchanged.
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