Registration Review

E-mail Address*

First Name*

Last Name*

Birth Date*

Gender*

MaleFemale

Ethnicity*

Address 1*

Address 2

City*

State*

Postal Code*

Country*

Phone*

Receive Text Messages*

YesNo

Additional Contact Name

Additional Contact Phone

Register Test Kit

The new blood spot card(s) will have an 8 digit code with the first 2 letters of OQ follow by 6 numbers.

Note: Blood spot cards in older kits will not have a barcode sticker, and will NOT need to be registered. You will write your Participant ID on your blood spot card(s), answer or update your questionnaire and mail in your blood spot card(s) in the provided return envelope. If your blood spot card does not have a barcode, you do not need to register your kit.

Barcode

Date of Collection

Time of Collection