Pay & arrange collection

Once you’ve completed the Medicheck test and you are ready to have your sample collected, complete the form below to pay and arrange collection by a courier. Your test will be collected at your preferred time and date (indicated below) and delivered to DNAlysis Biotechnology by a trusted courier, who will ensure your sample is kept safe – from the time of collection until delivery at our lab.

Your details
* First name
* Last name
* Email address
* Cell number
 
Order details
* Amount to pay
1 test + shipping = R3620.00
2 tests + shipping = R7120.00
* Reference number
e.g.: #MYGRX1xxxxx
 
Collection address
* Preffered date
* Preffered time
* Address line 1
   Address line 2
* City
* Province
* Country
* Postal code
Notes