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Choose online submission and receive a 5% discount!

Check for other discounts available to you before starting the ONLINE FORM.

Please check out Tips for successful online entry!
Order is not complete until you receive a "Thank You" screen!

NOTE: Credit Card Payment -the actual charge to your credit card account will be made at the time the sample is received at OptiGen.
Debit Card/Check Card Payments - may be processed immediately depending on the card issuer's policy. Please take this into consideration when choosing the form of payment. Thank you.

Online Form: complete and submit the form ONLINE
(You will get a printable confirmation page to include with your sample.)

or 

Printable Form: print a copy of the blank form to complete by hand and submit by mail
(Feel free to make multiple blank copies to distribute to others, but be sure to provide all pages.)