DNA TEST ACTIVATION &
HEALTH INFORMATION CONSENT
Activating Your DNA Test is Simple, Just Follow the 4 Steps Below:
Step 1. Purchase Your Desired Test.
Step 2. Collect Your DNA Sample
Step 3. Activate Your DNA Test by Completing this Health Information Consent Form.
Step 4. Ship Your DNA Sample with Your Completed and Signed Requisition Form, in the Provided Prepaid Shipping Envelope.
I am voluntarily submitting my DNA sample for analysis. If you are a parent or guardian consenting for your child or minor, all references to “I” are applicable to your child/minor. I understand that my sample(s) become the property of Safe Harbour Wellness and its Laboratory Partners. Safe Harbour Wellness or its Partners will never release any personal or identifiable information to a third-party without my consent.