REQUEST FORM FOR EQUINE DNA TESTING
* * NOTE: Please type or print legibly all information below * *
| Owner: | _______________________________ | Turnaround time: 7-10 business days |
| Address: | _______________________________ | Preliminary Report by: [ ] Phone [ ] FAX [ ] Email |
| _______________________________ | (Written report to be mailed within 4 weeks of results) | |
| Phone: | _______________________________ | COST = $40 for a single test/per horse (please ask us about volume discounts) |
| FAX: | _______________________________ | # of Additional Sampling Kits Needed: ______ |
| Email: | _______________________________ |
Submitted Samples
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Breed/Sex |
ID (Registry #, Name) |
Test(s) Requested |
For Lab Use |
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Please list any specific questions for
interpretation of the genetic testing results: |
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Payment Included: $____________ [ ] Check [ ] Visa [ ] MasterCard [ ] Coupon
Credit Card #________________________ Expiration: ___/___ Signature: ______________________
Pet DNA Services of AZ, PO Box 7809, Chandler, AZ 85246
Phone: 602-380-8552 Email: genes@petdnaservicesaz.com
Referred by Beth at Painted Sun Miniature Horses
