Make an Order

Order form E1

Section

Sender's details

Sender's details (internal)

Billing details

Please add invoicing details, which may be retained for future orders.
If any, please enter local tax code.
If any, please enter company / institution VAT number or tax code
(Street, number, postal code, city.

Billing details (internal)

Please add invoicing details, which may be retained for future orders.
If any, please enter local tax code.
If any, please enter company / institution VAT number or tax code
(Street, number, postal code, city.

Report options

(coma separated)

Patient's details

Please give as much clinical info as possible.
Please sepcify if this is a sigleton (solo), trio, or any other combination of relative testing.

Relative #1

Please don't forget to submit another order form also for this sample. This is recommended to get the P number also for parents and siblings.

Relative #2

Please don't forget to submit another order form also for this sample. This is recommended to get the P number also for parents and siblings.

Relative #3

Please don't forget to submit another order form also for this sample. This is recommended to get the P number also for parents and siblings.

Sample's details