Supply Order Form

Pharmacogenetic Testing, customers can order supplies with the form below. If you have an active account, please fill out the request form and submit it.

In order for us to fulfill your needs, information linked to your account should be used when completing the form, and all required/necessary fields need to be completed.

After the request has been submitted, a representative from Pharmacogenetic Testing, will be in contact with you to complete your request.

Keep in mind that pressing “submit” is NOT the final step for placing an order. You must speak with a representative before your order has been finalized. We will contact you promptly once we receive your online request. *We will never share, sell, or spam your contact information.

Supply Order Form

  • Supplies Requested

    Please enter desired quantity in the field below the corresponding item. If you do not see the item(s) in which you are interested, please use the Other field to type in a name, description, and quantity.

  • Stool Containers

  • Urine Containers

  • Tubes

  • Needles

  • Miscellaneous

  • This field is for validation purposes and should be left unchanged.