Client Intake Form

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Welcome to DNA Concierge Plus!!!

DNA CONCIERGE PLUS CLIENT ONLINE INTAKE FORM

Our intake form is designed to gather essential information for your DNA testing process. Please provide accurate details to ensure accurate results. Your privacy and confidentiality are top priority. Thank you for choosing DNA Concierge Plus for your genetic needs.

Party 1 Information
Party 2 Information
Party 3 Information (Child)
If this is for Immigration, do you have a legal case pending?
Is this for a Non-Invasive Prenatal Test or Gender Reveal?
Are there any domestic issues between the testing parties, where they can't be in the same room? for safety purposes only
Have you had a blood transfusion in the last 30 days?
Have you had a bone marrow or stem cell transplant?
Do you have any pets?
Do you understand that NO additional guests or pets are allowed during testing?
Disclaimer: Please note that the information provided on this form will be used solely for the purpose of DNA testing services by DNA Concierge Plus, backed by an AABB‑credentialed laboratory.

1. The initial $100 deposit is 100% non‑refundable unless canceled by DCP or an official party within 72 hours before the date of the test. Full payment is due the day of the test. A payment link will be sent 24 hours before the test or may be paid through this website. If payment is not received within 4 hours of testing, a collector will not be dispatched.

2. All additional mileage fees are due prior to dispatch. 50 miles roundtrip are included and are calculated from our headquarters: 137 N Oak Park Ave, Oak Park, IL 60301. Additional mileage is billed at $0.62 per mile after 50 miles roundtrip.

3. All parties must present valid photo ID (Driver’s License, State ID, or Passport). Children without photo ID must present a Birth Certificate and have a parent sign.

4. Photos will be taken of all parties and submitted with the DNA samples for identification purposes only.

5. Results will be emailed to the ordering party only. Postal mail delivery is available upon request within 5 business days of the test.

6. No additional guests or pets are allowed during testing. Testing takes approximately 15–30 minutes.

7. No food or drink 30 minutes before the test.

DNA Concierge Plus is committed to protecting your privacy. We will not share your personal information without your consent, except as required by law.
Photo ID of Party ordering test? (front only )
By signing this application, you authorize DNA Concierge Plus to charge your provided payment method for any and all DNA testing services, including but not limited to service balances and mileage fees, on the day of service.