Peekaboo^™ Kit Registration

Kit Registration (Prepaid Lab Fee)

Name*

First Last

Date of Birth*

Email*

Enter Email Confirm Email

Phone*

ZIP*

(i.e. XXXXX)

Product ID (located on Sample Tube)*

Date of sample collection*

This test has not been validated prior to the 6th week of pregnancy and we cannot guarantee accuracy of results if samples are submitted early. Please do not submit tests prior to the 6th week of pregnancy.

I confirm that I was at least 6 weeks pregnant at time of sample collection.*

Yes

No

First date of last menstrual cycle*

Estimated due date*

Contact Us

We want to hear from you!

DNA Technology Park

1 DDC WAY

Fairfield, OH 45014

1.800.681.6731 (USA)

1.513.881.7800 (INT)

9AM – 5PM ET M-F

[email protected]

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Peekaboo^™ Kit Registration