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Test Order Form

The information collected on the form below is solely used to ship a saliva collection kit to you. Nothing will be shared outside of this purpose.

Important: After submitting the order form, you will receive a Sample ID number via email. Please remember to write that Sample ID# and your Date of Birth in ink on the outside of the test tube before returning your sample. DO NOT write your name to keep your test confidential.​

Fill Out the Form Below to Get a Free Test Now!

Disclaimer: The services provided are not intended to inform you of your current state of health, or to be used to make medical decisions. Your test results should be shared with your healthcare provider. PML risk is dependent on multiple intrinsic and extrinsic factors, and if you have any concerns or questions about learnings from the PML Risk Test, you should contact your physician or healthcare provider. Always consult with your doctor before altering your medications. Any medication changes should be done only after proper evaluation and under medical supervision.

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