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Legal Testing Booking Form
You are currently protected by the 128-bit Secured Socket Layer (SSL) technology. Fields in
bold
are required.
Booking Information
Alleged Father
Mother
Child #1
Child #2
First Name
Last Name
Middle Name
Address
City
State / Province
Zip / Postal Code
Country
Phone
Date of Birth (yyyy-mm-dd)
Preferred City for Collection
Note: Please click the check box beside
Mother
or
Child #2
to fill in the required information if applicable.
Result Report Information
Recipient of Result Report
Alleged Father
Child #1
Mother
Child #2
Other (Please specify name, relationship, and address below)
Payment Information
Credit Card
Visa
MasterCard
Card Number
-
-
-
Expiry Date
(mm) /
(yy)
CVC Number
Cardholder Name
Note: Please select the method of payment. Credit cards only for online orders. To pay by international money order, call 1-888-262-2263 or download the printable test request form to order by mail.
Additional Information
Court Date
yyyy
mm
dd
Notes
