Forms / Resources

Forms

DNA Banking & Testing Consent Form (US)

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DNA Banking & Testing Consent Form (CA)

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Custom DNA Banking Authorization Form (FREE)

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Website Integration

Integrating DNA preservation services to your website is an important step for families to learn about this service. Simply copy and paste the video link below onto your website, or provide the link to your website management provider. If you require any assistance with video, text or image integration, please feel free to contact our web support team at web@securigene.com.

Media Assets

Website Integration Text

Option 1
Capture the entire genetic ‘blueprint’ of your loved one for generations to come with the SecuriGene DNA Capsule. DNA contains valuable information about a family’s health risks, medical conditions and ancestry. When a person passes away, this information is often lost forever – making DNA preservation a vital end-of-life consideration, especially for families with a history of cancer, heart disease and other hereditary health conditions. For more information on DNA preservation, please visit www.SecuriGene.com/video.
Option 2
[Insert Funeral Home Name Here] is proud to partner with SecuriGene to offer a new valuable memorial option for families: DNA Preservation. DNA encodes information about every individual, ranging from hair color, eye color and other physical traits, to inherited health risks, family medical conditions and ancestral origins. When a person passes away, this information is often lost forever – making DNA preservation a vital end-of-life consideration. This information can also be valuable for future healthcare purposes, as medical professionals are increasingly relying on genetic testing to determine different cancer types, optimal drug dosage levels, and heritable disease risks to help other members of the family. When you choose to preserve DNA, a small sample is collected by the funeral home and sent to the SecuriGene laboratory for processing. At the laboratory, DNA is extracted, purified, preserved, then hermetically sealed inside a glass and stainless steel SecuriGene DNA Capsule, which is returned to you along with full reports certifying the quantity and quality of the sample. Please note that DNA collection is no longer possible after cremation or burial. Should you wish to order this service, please notify your funeral service provider as soon as possible. For more information on DNA preservation, please visit www.SecuriGene.com/video.

Custom Form Request

Our in-house design team can create custom forms with your own logo and brand colors. Please fill out the information below and we will provide you with a proof via email. This service is complimentary.
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You will receive a proof of your Custom Form via email within 2 business days. In the meantime, you may order additional supplies here.
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