DNA Registration Form

Please note: Biotas must be informed if a close relative of the participants could be the true biological parent, e.g. the potential father's brother may be the true biological father. This will need additional interpretation when analysing the results. Please add this into the additional information section at the end of the Form.
Participant One
Name*
First Last
Relationship*

(e.g. Father)
Date of Birth*

Day
Month
Year
Ethnicity
Gender
Address
Street Address Address Line 2 Town / City Postcode Country
Telephone Number
Email
Who has Parental Responsibility

(Under 16s only)
Participant Two
Name
First Last
Relationship

(e.g. Father)
Date

Day
Month
Year
Ethnicity
Gender
Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Telephone Number
Email Address
Who has Parental Responsibility

(Under 16s only)

Participant Three
Name
First Last
Relationship

(e.g. Father)
Date

Day
Month
Year
Ethnicity
Gender
Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Telephone Number
Email Address
Who has Parental Responsibility

(Under 16s only)
Participant Four
Name
First Last
Relationship

(e.g. Father)
Date

Day
Month
Year
Ethnicity
Gender
Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Telephone Number
Email Address
Who has Parental Responsibility

(Under 16s only)

Sample Collection
- Legal and Immigration samples must be taken by an independent third party such as a GP, social worker or Embassy. We can arrange UK home sample collections if required.
- Instructions will be provided for Peace of Mind customers who wish to take their own samples at home. If the child is under 16 the mother must sign the consent form unless the father can prove he has legal guardianship i.e. is named on the birth certificate.
- Peace of Mind customers can also have their samples taken by their GP. This will incur an additional charge.
Please state in the table below the name of the person obtaining the sample and their address so that we can dispatch sampling kits.
Name of Client*
Sample to be taken by*
Sampler Address*
(Including Postcode)
Name of Client
Sample to be taken by
Sampler Address
(Including Postcode)
Name of Client
Sample to be taken by
Sampler Address
(Including Postcode)
Name of Client
Sample to be taken by
Sampler Address
(Including Postcode)

Report Distribution
- lease list below who is entitled to receive the report. The report will only be sent to the individuals listed below.
- All individuals over the age of 16 have the right to receive a copy of their DNA testing report. If an individual under the age of 16 is tested, any individual with parental responsibility may request a copy of the report.
Individual(s) or Establishment(s) responsible for receiving the report
Name*
Email Address*
Client Name*
Name
Email Address
Client Name
Name
Email Address
Client Name

Agreement
hereby request that Biotas carries out a DNA test in relation to the above-named persons and I accept their DNA testing Terms and Conditions and confirm I have read and understood the Biotas Privacy Notice. Both documents are available in a paper copy upon request.
Signature
Additional Information
Please notify BIOTAS of additional information using the box below. This may include the following:

For Legal or Immigration cases:
- Has the Court ordered testing pursuant to section 20 of the Family Law Reform Act 1969?
- Court Date
- If you require BIOTAS to inform the Home Office that we have begun processing your case. This only applies to Immigration Tests ordered by the UKBA or the Home Office.
- If you do not wish BIOTAS to send a copy of your report to the relevant Embassy, UKBA or Home Office Department please notify us.
For all cases:
- Any other information which you think may impact upon the test e.g., if a close relative of the tested person may be the true biological relative.
Additional Information

Participant One