Appointment Request

Peace of Mind Genetics is proud to be able to serve our clients needs around the
clock.  Allowing you to select collection times that work around your schedule.  

It’s easy to schedule an appointment:
1. Fill out all required information in the fields provided.
2. Make sure you request the most convenient time for you.
3. Submit your request and you will be given a confirmation via e-mail or by phone with
your appointment time and date.

To request a collection time please complete the following:
































































































*** Peace of Mind Genetics reserves the right to ask for a onetime fee of $25 per
appointment that will be applied towards clients total amount due. Fee will be forfeited if
client is a no call-no show or cancellation  occurs  less than 24 hours of scheduled time.
Click here to e-mail us with your questions regarding scheduling or general requests for
scheduling.
Appointment Requests
Choose a
Relationship
First Name:
 Last Name:
Email:
 Contact Phone Number:
City
 State:
 Zip:
Special Notes:
Choose a
Relationship
First Name:
 Last Name:
Email:
 Contact Phone Number:
City
 State:
 Zip:
Special Notes:
*Although, mother may not be tested,
her information must still be entered
with the exception of her Phone
Number. If mother is not being
tested, you will need to place
"Mother not Tested" in one of the
first name fields. If relationship is
not listed. Please use the special
notes area to explain th relationship.
Choose a
Relationship
First Name:
 Last Name:
Email:
 Contact Phone Number:
City
 State:
 Zip:
Special Notes:
* If there no other participants  to
enter. Please select "Other" and
Place N/A in all requested fields.
Choose a
Relationship
First Name:
Last Name:
Email:
 Contact Phone Number:
Zip:
City
 State:
Special Notes:
How did you hear about us?
Who sent you to us or
Where did you see us?
*** In areas below, all areas must be completed in order to process your request. If information is not available for a
     certain field then type in N/A to satisfy field request.
Peace of Mind Genetics
                                                                                                                                                                     314-714-5DNA (5362) or 800-621-1740
Peace of Mind begins with the truth. We'll Give you Both.