SHIPPING KIT
REQUEST

These kits are meant for shipment at room temperature only. Please refer to each specific test for appropriate shipping conditions.

For international shipping kit requests, please email genetictest@bmgl.com

If you would like to fax in your request, please use the pdf version of this form and fax the completed form to Client Services: 713-798-2787.

Attention: Baylor Genetics is now utilizing the services of Path-Tec, a leading provider of specimen management services, for sample kit production, fulfillment, and distribution.

All kits (excluding saliva Kits) contain these items: foam insert with cavities for vials & kit accessories, absorbent material, Parafilm, specimen labels, plastic biohazard bag, Clinical Pak, prepaid Airbill (Domestic shipping only), sample requisition, and instructions.

Recipient Name: *
Recipient Address: *
Recipient City: *
Recipient State: *
Recipient Zip: *
Recipient Phone:*
*
*
*
*



Select quantity of kit(s) desired
Cytogenetics / CMA:
Includes 1 (6ml) purple-top tube and 1 (4ml) green-top tube
DNA (Molecular) / Mitochondrial:
Includes 2 (6ml) purple-top tubes
Prenatal:
Includes 3 (15ml) blue-top tubes
Prenatal CMA:
Includes 3 (15ml) blue-top tubes and 2 (6ml) purple-top tubes
BRCA1/2 - Blood:
Includes 1 (4ml) purple-top tube
BRCA1/2 - Saliva:
Includes 1 saliva kit
BRCA1/2 - Blood and Saliva:
Includes 1 (4ml) purple-top tube and saliva kit
Cancer Molecular Studies - Blood and Bone Marrow:
Includes 2 (6ml) purple-top tubes
Cancer Cytogenetic Studies - Blood and Bone Marrow:
Includes 2 (4ml) green-top tubes
Hereditary Cancer Studies - Blood:
Includes 2 (6ml) purple-top tubes
Cancer Molecular and Cytogenetic Studies:
Includes 2 slide boxes capable of holding 5 slides each
Comprehensive Cancer Specimen Kit:
Includes 2 (6ml) purple-top tubes, 2 (4ml) green-top tubes, and 2 slide boxes capable of holding 5 slides each
Mitochondrial/Metabolic (MitoMet®):
Includes 1 (6ml) purple-top tube
Whole Exome Sequencing (WES):
Includes 3 (6ml) purple-top tubes
WES Parental Study - Saliva:
Includes 1 Saliva Kit
WES Parental Study - Blood:
Includes 1 (6ml) purple-top tube for each parent
Trio Whole Exome Sequencing (Trio WES):
Includes 5 (6ml) purple-top tubes
Eye Disorders - Blood:
Includes 1 (6ml) purple-top tube
Eye Disorders - Saliva:
Includes 1 saliva kit
NIPT:
Indicate 1 (10 ml) Streck tube OR 2 (10 ml each) Streck tubes needed in this kit in the comment section.
Global MAPS:
Includes 1 (6ml) purple-top tube, 1 (5ml) conical tube, 1 (5ml) screw cap for Plasma, 1 (2ml) screw cap for CSF
White Blood Cell Cystine:
Includes 1 (8.5 ml) yellow-top tube
Buccal Swab :
Includes 2 Buccal Swabs and 2 (5ml) tubes and caps



GeneAware Kits
Single GeneAware Kit - Blood:
Contains shipping box, one 4ml EDTA tube, absorbent material, Parafilm, one plastic biohazard bag, one Clinical Pak with pre-paid airbill, and instructions.



Delivery Service Supplies
Clinical Pak(s):
Airbill(s) ONLY - Prenatal:



Other
Shipping Box(es) for Bulk Shipping:
Absorbent Material ONLY:
Biohazard Bag(s) - Plastic ONLY:
Parafilm Square(s) ONLY:
EDTA (Purple-Top) Tube(s) ONLY:
Sodium Heparin (Green-Top) Tube(s) ONLY:
Empty 15ml Conical Tube(s) ONLY:
15ml Conical Tube(s) of CVS Tnspt Media:
Verifi Test Streck Tube(s) ONLY:
Empty Kit Boxes:
(Includes a foam insert)