Consent for Services

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Consent Options

Please check the applicable boxes and sign below:

I consent to the wellness genetic testing described above.

New York Patients Only: Your samples will be disposed of sixty (60) days after testing is complete, and will not be used for research or quality assurance purposes unless the box below has been checked.

I am a New York resident and I consent to the storage and use of my remnant sample and de-identified data for anonymous research. I authorize the Lab to retain my sample(s) longer based on the Lab's retention policy for test development, quality assurance, and training purposes.

Signature: *

Date:

A copy of this signed consent will be available for download after submission.