Request a Kit

Please fill out the following form to have one or more send-in kits delivered to you.

Lab Tests May Only Be Ordered by Authorized Healthcare Professionals: Laboratory tests from Insight Medical Genetics, LLC (Insight) may only be ordered through a licensed healthcare provider. Insight will not process any specimen for testing without a signed requisition form from a healthcare professional and shall discard the specimen if there is no such signed requisition form. Test requisition forms can be found here. If you would like to request a kit and are located outside the United States, please contact our Lab Counselor at [email protected]

Subject *

Name *

Name

First Name

Last Name

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address *

Phone Number *

Number of Kits *

Kit Type

Thank you for your request. You should expect your shipment in 5 business days.
If you need a kit more urgently, please email our Lab Counselor at [email protected]