Consent for DNA testing
in paternity determination
I, Xxxx Xxxxxx, identity number xxxx, Passport No. xxxx (issued: date, authority), certify with
my signature that I agree that GenEra LLC laboratory carries out DNA analysis of the tissue
samples taken from me for paternity determination. I am aware of the DNA analysis principles and
understand in full all information supplied to me.
 I agree that GenEra LLC employee takes saliva samples from me and my minor child Xxxx
Xxxxxxx, identity number xxxx, Birth Certificate LV XX xxxx;
 I do not object that genomic DNA is isolated (purified) from these samples;
 I understand that these manipulations will not be harmful to my and my family members’
health;
 I agree that the tests will be performed with my genomic DNA, which are required for
paternity approval or exclusion;
 I understand that any information identifying me will be confidential and my DNA samples
will be coded;
 I certify that in the previous two years I have not passed stem cell transplantation (blood
transfusion);
 I certify that I have no brothers/sisters, who would have been my one-egg twins;
 I do not object that my STR genotype (anonymously, without personal data) is used for
statistical studies on allele frequency;
 I certify that the child for whose paternity determination the DNA analysis is made was not
born as a result of assisted reproduction;
 I accept full responsibility for any consequences, if any of the tested child's parents does not
agree or is not informed about this analysis;
 I undertake to pay up the invoice issued to me (No. xxxxxxxx/2014 to the amount of EUR
xxx,-) before ___ __________ of this year.
Please have the test results:
o issued to me personally
o notified to me by telephone:
o sent to me by mail to the address:
o sent to my e-mail:
____________
dated
______________
signature /identity/
Apstiprinu, ka esmu informējis klientu par DNS analīzes gaitu, pamatprincipiem, iespējamiem
rezultātiem un klienta tiesībām. Apliecinu, ka klienta DNS paraugs tiks izmantots tikai klienta
pasūtītajai analīzei.
___________
dated
_________________
GenEra employee LLC
GenEra SIA, Rātsupītes Street 1, Riga LV-1067, Latvia, tel.: +37167425241; e-mail: info@genera.lv; www.genera.lv