
Step 3: Mailing your sampleīefore mailing remember to label your sample with your name and date of birth and write the date you collected your sample on the top of the Myriad Test Request Form. Please write the day you collected your sample within the provided box.Īlso add any missing insurance information and sign and date the bottom of the test request form. In the top center section of the test request form, either emailed or provided with your kit, is a specimen collection date.

If you did not receive a completed test request form, please contact Myriad customer service at 1-80 If sent via email you will need to print prior to shipping your sample. This test request form was either sent to you via email or sent with your kit. It’s important you keep your kit box as you will use it to ship back your sampleĪlong with your kit you should have also received a Test Request Form completed and signed by either your genetic counselor or physician.


