Genomics Testing Client Consent Form

Our genomics testing is done through Nutrigenomix. Please read over this consent form and agree by checking the box at the bottom prior to paying for your genomics test.

Name

First Name

Last Name

Date

YYYY

Consent Information

I have read, or have had read to me, all of the above statements and understand the information regarding Nutrigenomix testing. I have had the opportunity to ask any questions I have about the testing, procedure or risks prior to providing my consent. By providing my saliva sample I am consenting to Nutrigenomix testing and storage of my sample for future testing.

Checking this box provides my consent and electronic signature.