Phone: +1-715-387-0484

DNA Banking Forms

Documents For DNA Banking

Digital DNA Banking Forms

New Depositors

  1. DNA Banking Agreement - English
    • This Agreement contains provisions for the banking of a person's (the Depositor's) DNA.

  2. DNA Banking Agreement - Spanish

Existing Depositors

  1. Change of Representative
    • Please use this form if you have already banked your DNA with PreventionGenetics and would like to change or add your Representative.

  2. Change of Address
    • Depositor
      • Use this form if you have already banked your DNA with PreventionGenetics and would like to notify us of a change of address or name.

    • Representative
      • Use this form if you have already banked your DNA with PreventionGenetics and would like to notify us of a change of address or name.

  3. DNA Banking Withdrawal
    • Please use this form if you have already banked your DNA with PreventionGenetics and would like to withdraw and/or transfer a portion of this DNA.

  4. DNA Banking Kit Request
  5. Consent to Transfer Clinical Specimen
    • Consent to transfer a sample currently in PreventionGenetic's clinical lab to the DNA Bank.