Orders with MyAntegenes access
Partner's / Distributor's information:
Company Name
First and last Name
E-mail (CC address of order form)
Consultant name (optional)
Consultant's e-mail (optional)
Patient information:
DNA kit barcode number
First name
Family name
National identification number
Country of Residence
Date of birth (dd/mm/yyyy)
Ancestry EuropeanEast-AsianSouth-AsianAfricanMixed
Sex malefemale
E-mail (optional)
Comment (optional)
DNA kit shipping information (optional):
Address
City
Postal Code
Country
Phone
Select tests:
AnteCancerW (A set of genetic risk tests for women)AnteCancerM (A set of genetic risk tests for men)AnteBC (polygenic risk score test of breast cancer)AntePC (polygenic risk score test of prostate cancer)AnteCRC (polygenic risk score test of colorectal cancer)AnteMEL (polygenic risk score test of melanoma)
Consent:
By ordering this service I confirm that I take responsibility for obtaining and managing informed patient consent and that the patient has been made aware of data processing under the provisions of Antegenes terms of use and privacy conditions
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