blueprintgenetics.com Open in urlscan Pro
162.159.135.42 Public Scan

Back to summary

Submitted URL:
http://blueprintgenetics.com/
Effective URL:
https://blueprintgenetics.com/
Submission: On January 23 via manual (January 23rd 2023, 5:17:15 pm UTC) from CA — Scanned from CA

Form analysis
2 forms found in the DOM

https://blueprintgenetics.com

<form class="js-search-form " action="https://blueprintgenetics.com" role="search">
  <div class="input-group d-flex js-search-input-group">
    <label for="site-header-site-search" class="sr-only"> Search </label>
    <input type="search" id="site-header-site-search" class="form-control js-site-header__site-search-field  custom-form-control  input-search" placeholder="Search" name="s" value="">
    <div class="input-group-btn search-btn-group col">
      <button class="btn btn-search  js-search-btn" type="submit"><span class="sr-only">Search</span><!--?xml version="1.0" encoding="utf-8"?-->
        <svg version="1.1" class="icon icon-search" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" viewBox="0 0 24 24" enable-background="new 0 0 24 24" xml:space="preserve">
          <g>
            <path d="M9,18c2.131,0,4.089-0.749,5.633-1.992l7.658,7.697c0.389,0.392,1.021,0.394,1.414,0.003
		c0.392-0.39,0.393-1.023,0.004-1.414l-7.668-7.707C17.264,13.052,18,11.111,18,9c0-4.963-4.037-9-9-9S0,4.037,0,9
		C0,13.962,4.037,18,9,18z M9,2c3.859,0,7,3.14,7,7c0,3.859-3.141,7-7,7c-3.86,0-7-3.141-7-7C2,5.14,5.14,2,9,2z"></path>
          </g>
        </svg>
      </button>
    </div>
  </div>
</form>

POST /#gf_1

<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_1" id="gform_1" action="/#gf_1" novalidate="" class="recaptcha-v3-initialized">
  <div class="gf_invisible ginput_recaptchav3" data-sitekey="6Le2jqsUAAAAAAQkxm8nOv_4r58bi0ASZn2lAIUA" data-tabindex="0"><input id="input_349fe37945735a57ab53ecc7970b4750" class="gfield_recaptcha_response" type="hidden"
      name="input_349fe37945735a57ab53ecc7970b4750" value=""></div>
  <div class="gform_body gform-body">
    <div id="gform_fields_1" class="gform_fields top_label form_sublabel_above description_below">
      <div id="field_1_18" class="gfield gsection field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_18">
        <h3 class="gsection_title">Health Care Professional (HCP) Information</h3>
      </div>
      <fieldset id="field_1_2" class="gfield gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_2">
        <legend class="gfield_label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name" id="input_1_2">
          <span id="input_1_2_3_container" class="name_first">
            <label for="input_1_2_3">First</label>
            <input type="text" name="input_2.3" id="input_1_2_3" value="" aria-required="true">
          </span>
          <span id="input_1_2_6_container" class="name_last">
            <label for="input_1_2_6">Last</label>
            <input type="text" name="input_2.6" id="input_1_2_6" value="" aria-required="true">
          </span>
        </div>
      </fieldset>
      <div id="field_1_3" class="gfield gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_3"><label class="gfield_label" for="input_1_3">Institution<span
            class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_text"><input name="input_3" id="input_1_3" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
      </div>
      <div id="field_1_20" class="gfield gfield--width-full gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_20"><label class="gfield_label" for="input_1_20">Title<span
            class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><select name="input_20" id="input_1_20" class="large gfield_select" aria-required="true" aria-invalid="false">
            <option value="" selected="selected" class="gf_placeholder">Choose your title</option>
            <option value="Doctor">Doctor</option>
            <option value="Genetic counsellor">Genetic counsellor</option>
            <option value="Other health care provider">Other health care provider</option>
          </select></div>
      </div>
      <div id="field_1_29" class="gfield gfield--width-full gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_29"><label class="gfield_label" for="input_1_29">Phone<span
            class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_phone"><input name="input_29" id="input_1_29" type="tel" value="" class="large" placeholder="Your phone number" aria-required="true" aria-invalid="false"></div>
      </div>
      <div id="field_1_5" class="gfield gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_5"><label class="gfield_label" for="input_1_5">Email<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_email">
          <input name="input_5" id="input_1_5" type="email" value="" class="large" placeholder="Your institutional email adress" aria-required="true" aria-invalid="false">
        </div>
      </div>
      <div id="field_1_19" class="gfield gsection field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_19">
        <h3 class="gsection_title">Delivery Information</h3>
      </div>
      <fieldset id="field_1_1" class="gfield gfield--width-full field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_1">
        <legend class="gfield_label gfield_label_before_complex">Deliver Kit to Patient</legend>
        <div class="ginput_container ginput_container_checkbox">
          <div class="gfield_checkbox" id="input_1_1">
            <div class="gchoice gchoice_1_1_1">
              <input class="gfield-choice-input" name="input_1.1" type="checkbox" value="Deliver Kit to Patient" id="choice_1_1_1">
              <label for="choice_1_1_1" id="label_1_1_1">Deliver Kit to Patient</label>
            </div>
          </div>
        </div>
      </fieldset>
      <fieldset id="field_1_6" class="gfield gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_6" style="display: none;">
        <legend class="gfield_label gfield_label_before_complex">Patient Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name" id="input_1_6">
          <span id="input_1_6_3_container" class="name_first">
            <label for="input_1_6_3">First</label>
            <input type="text" name="input_6.3" id="input_1_6_3" value="" aria-required="true" disabled="disabled">
          </span>
          <span id="input_1_6_6_container" class="name_last">
            <label for="input_1_6_6">Last</label>
            <input type="text" name="input_6.6" id="input_1_6_6" value="" aria-required="true" disabled="disabled">
          </span>
        </div>
      </fieldset>
      <div id="field_1_28" class="gfield gfield--width-full gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_28" style="display: none;"><label class="gfield_label"
          for="input_1_28">Order ID<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_text"><input name="input_28" id="input_1_28" type="text" value="" class="large" aria-describedby="gfield_description_1_28" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
        <div class="gfield_description" id="gfield_description_1_28">You can find Order ID in Nucleus, our ordering portal.</div>
      </div>
      <fieldset id="field_1_7" class="gfield js-prefill-address-country gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_7">
        <legend class="gfield_label gfield_label_before_complex">Delivery Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
        <div class="ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address" id="input_1_7">
          <span class="ginput_full address_line_1 ginput_address_line_1" id="input_1_7_1_container">
            <label for="input_1_7_1" id="input_1_7_1_label">Street Address</label>
            <input type="text" name="input_7.1" id="input_1_7_1" value="" aria-required="true">
          </span><span class="ginput_full address_line_2 ginput_address_line_2" id="input_1_7_2_container">
            <label for="input_1_7_2" id="input_1_7_2_label">Address Line 2</label>
            <input type="text" name="input_7.2" id="input_1_7_2" value="" aria-required="false">
          </span><span class="ginput_left address_zip ginput_address_zip" id="input_1_7_5_container">
            <label for="input_1_7_5" id="input_1_7_5_label">ZIP / Postal Code</label>
            <input type="text" name="input_7.5" id="input_1_7_5" value="" aria-required="true">
          </span><span class="ginput_right address_city ginput_address_city" id="input_1_7_3_container">
            <label for="input_1_7_3" id="input_1_7_3_label">City</label>
            <input type="text" name="input_7.3" id="input_1_7_3" value="" aria-required="true">
          </span><span class="ginput_left address_state ginput_address_state" id="input_1_7_4_container">
            <label for="input_1_7_4" id="input_1_7_4_label">State / Province / Region</label>
            <input type="text" name="input_7.4" id="input_1_7_4" value="" aria-required="true">
          </span><span class="ginput_right address_country ginput_address_country" id="input_1_7_6_container">
            <label for="input_1_7_6" id="input_1_7_6_label">Country</label>
            <select name="input_7.6" id="input_1_7_6" aria-required="true">
              <option value="" selected="selected"></option>
              <option value="AF">Afghanistan</option>
              <option value="AL">Albania</option>
              <option value="DZ">Algeria</option>
              <option value="AS">American Samoa</option>
              <option value="AD">Andorra</option>
              <option value="AO">Angola</option>
              <option value="AI">Anguilla</option>
              <option value="AQ">Antarctica</option>
              <option value="AG">Antigua and Barbuda</option>
              <option value="AR">Argentina</option>
              <option value="AM">Armenia</option>
              <option value="AW">Aruba</option>
              <option value="AU">Australia</option>
              <option value="AT">Austria</option>
              <option value="AZ">Azerbaijan</option>
              <option value="BS">Bahamas</option>
              <option value="BH">Bahrain</option>
              <option value="BD">Bangladesh</option>
              <option value="BB">Barbados</option>
              <option value="BY">Belarus</option>
              <option value="BE">Belgium</option>
              <option value="BZ">Belize</option>
              <option value="BJ">Benin</option>
              <option value="BM">Bermuda</option>
              <option value="BT">Bhutan</option>
              <option value="BO">Bolivia</option>
              <option value="BQ">Bonaire, Sint Eustatius and Saba</option>
              <option value="BA">Bosnia and Herzegovina</option>
              <option value="BW">Botswana</option>
              <option value="BV">Bouvet Island</option>
              <option value="BR">Brazil</option>
              <option value="IO">British Indian Ocean Territory</option>
              <option value="BN">Brunei Darussalam</option>
              <option value="BG">Bulgaria</option>
              <option value="BF">Burkina Faso</option>
              <option value="BI">Burundi</option>
              <option value="CV">Cabo Verde</option>
              <option value="KH">Cambodia</option>
              <option value="CM">Cameroon</option>
              <option value="CA">Canada</option>
              <option value="KY">Cayman Islands</option>
              <option value="CF">Central African Republic</option>
              <option value="TD">Chad</option>
              <option value="CL">Chile</option>
              <option value="CN">China</option>
              <option value="CX">Christmas Island</option>
              <option value="CC">Cocos Islands</option>
              <option value="CO">Colombia</option>
              <option value="KM">Comoros</option>
              <option value="CG">Congo</option>
              <option value="CD">Congo, Democratic Republic of the</option>
              <option value="CK">Cook Islands</option>
              <option value="CR">Costa Rica</option>
              <option value="HR">Croatia</option>
              <option value="CU">Cuba</option>
              <option value="CW">Curaçao</option>
              <option value="CY">Cyprus</option>
              <option value="CZ">Czechia</option>
              <option value="CI">Côte d'Ivoire</option>
              <option value="DK">Denmark</option>
              <option value="DJ">Djibouti</option>
              <option value="DM">Dominica</option>
              <option value="DO">Dominican Republic</option>
              <option value="EC">Ecuador</option>
              <option value="EG">Egypt</option>
              <option value="SV">El Salvador</option>
              <option value="GQ">Equatorial Guinea</option>
              <option value="ER">Eritrea</option>
              <option value="EE">Estonia</option>
              <option value="SZ">Eswatini</option>
              <option value="ET">Ethiopia</option>
              <option value="FK">Falkland Islands</option>
              <option value="FO">Faroe Islands</option>
              <option value="FJ">Fiji</option>
              <option value="FI">Finland</option>
              <option value="FR">France</option>
              <option value="GF">French Guiana</option>
              <option value="PF">French Polynesia</option>
              <option value="TF">French Southern Territories</option>
              <option value="GA">Gabon</option>
              <option value="GM">Gambia</option>
              <option value="GE">Georgia</option>
              <option value="DE">Germany</option>
              <option value="GH">Ghana</option>
              <option value="GI">Gibraltar</option>
              <option value="GR">Greece</option>
              <option value="GL">Greenland</option>
              <option value="GD">Grenada</option>
              <option value="GP">Guadeloupe</option>
              <option value="GU">Guam</option>
              <option value="GT">Guatemala</option>
              <option value="GG">Guernsey</option>
              <option value="GN">Guinea</option>
              <option value="GW">Guinea-Bissau</option>
              <option value="GY">Guyana</option>
              <option value="HT">Haiti</option>
              <option value="HM">Heard Island and McDonald Islands</option>
              <option value="VA">Holy See</option>
              <option value="HN">Honduras</option>
              <option value="HK">Hong Kong</option>
              <option value="HU">Hungary</option>
              <option value="IS">Iceland</option>
              <option value="IN">India</option>
              <option value="ID">Indonesia</option>
              <option value="IR">Iran</option>
              <option value="IQ">Iraq</option>
              <option value="IE">Ireland</option>
              <option value="IM">Isle of Man</option>
              <option value="IL">Israel</option>
              <option value="IT">Italy</option>
              <option value="JM">Jamaica</option>
              <option value="JP">Japan</option>
              <option value="JE">Jersey</option>
              <option value="JO">Jordan</option>
              <option value="KZ">Kazakhstan</option>
              <option value="KE">Kenya</option>
              <option value="KI">Kiribati</option>
              <option value="KP">Korea, Democratic People's Republic of</option>
              <option value="KR">Korea, Republic of</option>
              <option value="KW">Kuwait</option>
              <option value="KG">Kyrgyzstan</option>
              <option value="LA">Lao People's Democratic Republic</option>
              <option value="LV">Latvia</option>
              <option value="LB">Lebanon</option>
              <option value="LS">Lesotho</option>
              <option value="LR">Liberia</option>
              <option value="LY">Libya</option>
              <option value="LI">Liechtenstein</option>
              <option value="LT">Lithuania</option>
              <option value="LU">Luxembourg</option>
              <option value="MO">Macao</option>
              <option value="MG">Madagascar</option>
              <option value="MW">Malawi</option>
              <option value="MY">Malaysia</option>
              <option value="MV">Maldives</option>
              <option value="ML">Mali</option>
              <option value="MT">Malta</option>
              <option value="MH">Marshall Islands</option>
              <option value="MQ">Martinique</option>
              <option value="MR">Mauritania</option>
              <option value="MU">Mauritius</option>
              <option value="YT">Mayotte</option>
              <option value="MX">Mexico</option>
              <option value="FM">Micronesia</option>
              <option value="MD">Moldova</option>
              <option value="MC">Monaco</option>
              <option value="MN">Mongolia</option>
              <option value="ME">Montenegro</option>
              <option value="MS">Montserrat</option>
              <option value="MA">Morocco</option>
              <option value="MZ">Mozambique</option>
              <option value="MM">Myanmar</option>
              <option value="NA">Namibia</option>
              <option value="NR">Nauru</option>
              <option value="NP">Nepal</option>
              <option value="NL">Netherlands</option>
              <option value="NC">New Caledonia</option>
              <option value="NZ">New Zealand</option>
              <option value="NI">Nicaragua</option>
              <option value="NE">Niger</option>
              <option value="NG">Nigeria</option>
              <option value="NU">Niue</option>
              <option value="NF">Norfolk Island</option>
              <option value="MK">North Macedonia</option>
              <option value="MP">Northern Mariana Islands</option>
              <option value="NO">Norway</option>
              <option value="OM">Oman</option>
              <option value="PK">Pakistan</option>
              <option value="PW">Palau</option>
              <option value="PS">Palestine, State of</option>
              <option value="PA">Panama</option>
              <option value="PG">Papua New Guinea</option>
              <option value="PY">Paraguay</option>
              <option value="PE">Peru</option>
              <option value="PH">Philippines</option>
              <option value="PN">Pitcairn</option>
              <option value="PL">Poland</option>
              <option value="PT">Portugal</option>
              <option value="PR">Puerto Rico</option>
              <option value="QA">Qatar</option>
              <option value="RO">Romania</option>
              <option value="RU">Russian Federation</option>
              <option value="RW">Rwanda</option>
              <option value="RE">Réunion</option>
              <option value="BL">Saint Barthélemy</option>
              <option value="SH">Saint Helena, Ascension and Tristan da Cunha</option>
              <option value="KN">Saint Kitts and Nevis</option>
              <option value="LC">Saint Lucia</option>
              <option value="MF">Saint Martin</option>
              <option value="PM">Saint Pierre and Miquelon</option>
              <option value="VC">Saint Vincent and the Grenadines</option>
              <option value="WS">Samoa</option>
              <option value="SM">San Marino</option>
              <option value="ST">Sao Tome and Principe</option>
              <option value="SA">Saudi Arabia</option>
              <option value="SN">Senegal</option>
              <option value="RS">Serbia</option>
              <option value="SC">Seychelles</option>
              <option value="SL">Sierra Leone</option>
              <option value="SG">Singapore</option>
              <option value="SX">Sint Maarten</option>
              <option value="SK">Slovakia</option>
              <option value="SI">Slovenia</option>
              <option value="SB">Solomon Islands</option>
              <option value="SO">Somalia</option>
              <option value="ZA">South Africa</option>
              <option value="GS">South Georgia and the South Sandwich Islands</option>
              <option value="SS">South Sudan</option>
              <option value="ES">Spain</option>
              <option value="LK">Sri Lanka</option>
              <option value="SD">Sudan</option>
              <option value="SR">Suriname</option>
              <option value="SJ">Svalbard and Jan Mayen</option>
              <option value="SE">Sweden</option>
              <option value="CH">Switzerland</option>
              <option value="SY">Syria Arab Republic</option>
              <option value="TW">Taiwan</option>
              <option value="TJ">Tajikistan</option>
              <option value="TZ">Tanzania, the United Republic of</option>
              <option value="TH">Thailand</option>
              <option value="TL">Timor-Leste</option>
              <option value="TG">Togo</option>
              <option value="TK">Tokelau</option>
              <option value="TO">Tonga</option>
              <option value="TT">Trinidad and Tobago</option>
              <option value="TN">Tunisia</option>
              <option value="TM">Turkmenistan</option>
              <option value="TC">Turks and Caicos Islands</option>
              <option value="TV">Tuvalu</option>
              <option value="TR">Türkiye</option>
              <option value="UM">US Minor Outlying Islands</option>
              <option value="UG">Uganda</option>
              <option value="UA">Ukraine</option>
              <option value="AE">United Arab Emirates</option>
              <option value="GB">United Kingdom</option>
              <option value="US">United States</option>
              <option value="UY">Uruguay</option>
              <option value="UZ">Uzbekistan</option>
              <option value="VU">Vanuatu</option>
              <option value="VE">Venezuela</option>
              <option value="VN">Viet Nam</option>
              <option value="VG">Virgin Islands, British</option>
              <option value="VI">Virgin Islands, U.S.</option>
              <option value="WF">Wallis and Futuna</option>
              <option value="EH">Western Sahara</option>
              <option value="YE">Yemen</option>
              <option value="ZM">Zambia</option>
              <option value="ZW">Zimbabwe</option>
              <option value="AX">Åland Islands</option>
            </select>
          </span>
          <div class="gf_clear gf_clear_complex"></div>
        </div>
      </fieldset>
      <div id="field_1_22" class="gfield gsection field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_22" style="display: none;">
        <h3 class="gsection_title">Information for customers in New York state</h3>
        <div class="gsection_description" id="gfield_description_1_22">At this time, we are unable to process any orders from New York State, outside of sponsored testing. Please note Familial Variant Testing (FVT) and Targeted Variant Testing (TVT)
          are also not available at this time to New York patients, even following use of a sponsored test. We apologize for any inconvenience this may cause clinicians or patients in New York State. You can order kits for sponsored testing (i.e. My
          Retina Tracker and Resonate Program) below. If you have any questions please contact: support.us@blueprintgenetics.com.</div>
      </div>
      <div id="field_1_9" class="gfield gsection field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_9">
        <h3 class="gsection_title">Kit Types</h3>
        <div class="gsection_description" id="gfield_description_1_9">If you wish to order more than 10 kits per type and/or 30 in total, please
          <a href="/contact/" target="_blank" rel="noopener"><strong>contact our customer support team</strong></a>.</div>
      </div>
      <div id="field_1_11" class="gfield gfield--width-full gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_11"><label class="gfield_label" for="input_1_11">Number of Buccal
          Swab Kits<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_number"><input name="input_11" id="input_1_11" type="number" step="any" min="0" max="10" value="0" class="large" placeholder="None" aria-required="true" aria-invalid="false"
            aria-describedby="gfield_instruction_1_11">
          <div class="instruction " id="gfield_instruction_1_11">Please enter a number from <strong>0</strong> to <strong>10</strong>.</div>
        </div>
      </div>
      <div id="field_1_23" class="gfield gfield--width-full gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_23"><label class="gfield_label" for="input_1_23">Number of Blood
          Kits<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_number"><input name="input_23" id="input_1_23" type="number" step="any" min="0" max="10" value="0" class="large" placeholder="None" aria-required="true" aria-invalid="false"
            aria-describedby="gfield_instruction_1_23">
          <div class="instruction " id="gfield_instruction_1_23">Please enter a number from <strong>0</strong> to <strong>10</strong>.</div>
        </div>
      </div>
      <div id="field_1_21" class="gfield gfield--width-full gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_21"><label class="gfield_label" for="input_1_21">Number of Exome
          Buccal Swab Kits<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_number"><input name="input_21" id="input_1_21" type="number" step="any" min="0" max="10" value="0" class="large" placeholder="None" aria-required="true" aria-invalid="false"
            aria-describedby="gfield_instruction_1_21">
          <div class="instruction " id="gfield_instruction_1_21">Please enter a number from <strong>0</strong> to <strong>10</strong>.</div>
        </div>
      </div>
      <div id="field_1_12" class="gfield gfield--width-full gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_12"><label class="gfield_label" for="input_1_12">Number of Exome
          Blood Kits<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_number"><input name="input_12" id="input_1_12" type="number" step="any" min="0" max="10" value="0" class="large" placeholder="None" aria-required="true" aria-invalid="false"
            aria-describedby="gfield_instruction_1_12">
          <div class="instruction " id="gfield_instruction_1_12">Please enter a number from <strong>0</strong> to <strong>10</strong>.</div>
        </div>
      </div>
      <div id="field_1_13" class="gfield gfield--width-full gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_13" style="display: none;"><label class="gfield_label"
          for="input_1_13">Number of My Retina Tracker Blood Kits<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_number"><input name="input_13" id="input_1_13" type="number" step="any" min="0" max="100" value="0" class="large" placeholder="None" aria-required="true" aria-invalid="false"
            aria-describedby="gfield_instruction_1_13" disabled="disabled">
          <div class="instruction " id="gfield_instruction_1_13">Please enter a number from <strong>0</strong> to <strong>100</strong>.</div>
        </div>
      </div>
      <div id="field_1_14" class="gfield gfield--width-full gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_14" style="display: none;"><label class="gfield_label"
          for="input_1_14">Number of My Retina Tracker Buccal Swab Kits<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_number"><input name="input_14" id="input_1_14" type="number" step="any" min="0" max="100" value="0" class="large" placeholder="None" aria-required="true" aria-invalid="false"
            aria-describedby="gfield_instruction_1_14" disabled="disabled">
          <div class="instruction " id="gfield_instruction_1_14">Please enter a number from <strong>0</strong> to <strong>100</strong>.</div>
        </div>
      </div>
      <div id="field_1_15" class="gfield gfield--width-full gfield_contains_required field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_15" style="display: none;"><label class="gfield_label"
          for="input_1_15">Number of Resonate Program Buccal Swab Kits<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_number"><input name="input_15" id="input_1_15" type="number" step="any" min="0" max="100" value="0" class="large" placeholder="None" aria-required="true" aria-invalid="false"
            aria-describedby="gfield_instruction_1_15" disabled="disabled">
          <div class="instruction " id="gfield_instruction_1_15">Please enter a number from <strong>0</strong> to <strong>100</strong>.</div>
        </div>
      </div>
      <div id="field_1_17" class="gfield field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_17"><label class="gfield_label" for="input_1_17">Other Information</label>
        <div class="ginput_container ginput_container_textarea"><textarea name="input_17" id="input_1_17" class="textarea small" aria-invalid="false" rows="10" cols="50"></textarea></div>
      </div>
      <div id="field_1_30" class="gfield gform_validation_container field_sublabel_above field_description_below gfield_visibility_visible" data-js-reload="field_1_30"><label class="gfield_label" for="input_1_30">Phone</label>
        <div class="ginput_container"><input name="input_30" id="input_1_30" type="text" value="" autocomplete="new-password"></div>
        <div class="gfield_description" id="gfield_description_1_30">This field is for validation purposes and should be left unchanged.</div>
      </div>
    </div>
  </div>
  <div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_1" class="gform_button button" value="Submit"
      onclick="if(window[&quot;gf_submitting_1&quot;]){return false;}  if( !jQuery(&quot;#gform_1&quot;)[0].checkValidity || jQuery(&quot;#gform_1&quot;)[0].checkValidity()){window[&quot;gf_submitting_1&quot;]=true;}  "
      onkeypress="if( event.keyCode == 13 ){ if(window[&quot;gf_submitting_1&quot;]){return false;} if( !jQuery(&quot;#gform_1&quot;)[0].checkValidity || jQuery(&quot;#gform_1&quot;)[0].checkValidity()){window[&quot;gf_submitting_1&quot;]=true;}  jQuery(&quot;#gform_1&quot;).trigger(&quot;submit&quot;,[true]); }">
    <input type="hidden" name="gform_ajax" value="form_id=1&amp;title=&amp;description=1&amp;tabindex=-1">
    <input type="hidden" class="gform_hidden" name="is_submit_1" value="1">
    <input type="hidden" class="gform_hidden" name="gform_submit" value="1">
    <input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
    <input type="hidden" class="gform_hidden" name="state_1" value="WyJbXSIsIjA0MjRmOWY3Nzg3N2NkZDE0MDQxZTRkNTQ2M2JlZDFlIl0=">
    <input type="hidden" class="gform_hidden" name="gform_target_page_number_1" id="gform_target_page_number_1" value="0">
    <input type="hidden" class="gform_hidden" name="gform_source_page_number_1" id="gform_source_page_number_1" value="1">
    <input type="hidden" name="gform_field_values" value="">
  </div>
</form>

Text Content

Blueprint Genetics
 * Diagnostic tests
   Menu Diagnostic tests
   
   TESTS
   
    * Panels
    * Whole Exome Sequencing
    * Single Gene Tests
    * Variant Specific Testing
    * What to Order?
   
   PANELS
   
    * Cardiology
    * Dermatology
    * Ear, Nose & Throat
    * Endocrinology
    * Gastroenterology
    * Hematology
    * Hereditary Cancer
    * Immunology
    * Malformations
    * Metabolic Disorders
    * Mitochondrial Disorders
    * Nephrology
    * Neurology
    * Ophthalmology
    * Pediatrics
    * Pulmonology
   
   SERVICES
   
    * Expansion service
    * Customization of Diagnostic Panels
    * Re-evaluation and Re-analysis Service
    * VUS Clarification Service
    * Clinical Genetics Support
   
   FREQUENTLY ORDERED
   
    * Whole Exome Family Plus
    * My Retina Tracker Program Panel
    * Retinal Dystrophy Panel
    * Aorta Panel
    * Cardiomyopathy Panel
    * Comprehensive Epilepsy Panel
    * Hypertrophic Cardiomyopathy (HCM) Panel
    * Primary Immunodeficiency (PID) and Primary Ciliary Dyskinesia (PCD) Panel
    * Familial Variant Testing

 * Testing with us
   Menu Testing with us
   
   ORDER
   
    * Nucleus
    * How to Order
    * Order Specimen Kit
    * Sample requirements
   
   PRICING
   
    * Pricing
    * Billing and Insurance
   
   CLINICAL REPORT
   
    * Sample Report
    * Clinical Consultants
    * Interpretation
   
   LEARN MORE
   
    * Diagnostic Process
    * FAQs

 * Technology
   Menu Technology
   
   INNOVATIVE SOLUTIONS
   
    * Analysis Methods
    * Data Analysis
    * Interpretation
   
   TRANSPARENT QUALITY
   
    * Variant Classification
    * Quality Control & Transparency
    * Policy for difficult-to-sequence regions
   
   ACCESSIBILITY
   
    * Nucleus

 * About us
   Menu About us
   
   BLUEPRINT GENETICS
   
    * In Short
    * Careers
    * Contact
   
   ACCREDITATION
   
    * Accreditations & Certifications
   
   NEWSROOM
   
    * News
   
   MEET US
   
    * Events

 * Resources
   Menu Resources
   
   RESOURCES
   
    * All resources
    * Insights
    * Posters
    * Publications
    * Videos
   
   EDUCATION
   
    * Webinars
    * White papers

 * Patients

Search
Search
Toggle search bar
Login to Nucleus
Toggle main menu




HOME

Explore our on-demand webinars
Access our educational resources
Watch now

EDUCATION
Insights
Mitochondrial genome analysis increases the diagnostic yield of genetic testing
Videos
A Genotype-First Approach to WES
RESOURCES
Webinars
December 08, 2022, 9:00 AM PST / 6:00 PM CET
Taking a Pulse on 10 Years in Cardiac Genetics
Insights
Infographic Skeletal Dysplasia Infographic: Clinical Overview and Testing
Videos
Interview Rare Journeys: Mom, Patient, Advocate
NEWS
Our service hours during the holiday season
Blueprint Genetics, a quality leader in genetic testing, embraces new EU
regulation (IVDR)
Blueprint Genetics further enhances the clinical utility of its testing offering
with a major panel update
Blueprint Genetics and BioMarin collaborate to launch a sponsored testing
program for individuals with skeletal dysplasia in Europe and the Middle East
Meet our team

“I adore the blend of tech and science in bioinformatics, an amazing field I
fell for little by little.” – Sohrab

Who we are



TESTS


WHAT TO ORDER?


WHOLE EXOME
SEQUENCING


FLEX PANELS


FAMILIAL VARIANT
TESTING


EXPLORE ALL MEDICAL SPECIALTIES

PULMONOLOGY



MITOCHONDRIAL DISORDERS



HEREDITARY CANCER



MALFORMATIONS



METABOLIC DISORDERS



CARDIOLOGY



NEUROLOGY



ENDOCRINOLOGY



IMMUNOLOGY



HEMATOLOGY



NEPHROLOGY



OPHTHALMOLOGY



EAR, NOSE & THROAT



DERMATOLOGY



GASTROENTEROLOGY



PEDIATRICS


Nucleus: Easy ordering platform for clinicians

Sign in


The genetic services of Blueprint Genetics were highly professional. Their
results came in due time, together with a thorough and insightful
interpretation, reflecting high professional standards. We were very pleased
with this collaboration and wish to continue it.

— Dr. R. Jurcut, Cardiologist, cardiomyopathy expert


GET OUR LATEST UPDATES DIRECTLY TO YOUR MAILBOX.

Subscribe

SUBSCRIBE NEWSLETTER

×
Note: due to a temporary technical limitation the newsletter subscription form
below does not load in some browsers if cookies have not been allowed. If you do
not see the form below, please allow cookies by clicking here to open the cookie
preference centre, then allow cookies and reload this page. You can disallow
cookies once you have signed up if you wish.
 * BpG in short
 * Accreditations & Certifications

 * Careers
 * Contact
 * Billing and Insurance

 * General Terms
 * Cookie Policy
 * Privacy

 * News
 * Events

 * Follow us
 * 
 * 
 * 

Copyright © 2023 Blueprint Genetics Oy. Cookie Preferences
Created by Kaimana.

ORDER A SPECIMEN KIT

×
Select your country Afghanistan Åland Islands Albania Algeria American Samoa
Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba
Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium
Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint
Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British
Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia
Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile
China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the
Democratic Republic of the Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba
Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic
Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland
Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French
Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana
Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea
Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican
City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic
Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan
Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic
of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho
Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, the former
Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall
Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated
States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco
Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand
Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman
Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay
Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania
Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan
da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint
Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome
and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint
Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa
South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan
Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab
Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of
Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey
Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates
United Kingdom United States United States Minor Outlying Islands Uruguay
Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Viet Nam Virgin Islands,
British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia
Zimbabwe
Please be advised that we only accept specimen collection kit requests from
medical professionals.
If you are a patient or family member of a patient, please contact your provider
to place a kit order on your behalf. You can order up to 10 kits per type and 30
kits total. If you need more kits, please contact our customer support team.



"*" indicates required fields


HEALTH CARE PROFESSIONAL (HCP) INFORMATION

Name*
First Last
Institution*

Title*
Choose your titleDoctorGenetic counsellorOther health care provider
Phone*

Email*



DELIVERY INFORMATION

Deliver Kit to Patient
Deliver Kit to Patient
Patient Name*
First Last
Order ID*

You can find Order ID in Nucleus, our ordering portal.
Delivery Address*
Street Address Address Line 2 ZIP / Postal Code City State / Province / Region
Country AfghanistanAlbaniaAlgeriaAmerican
SamoaAndorraAngolaAnguillaAntarcticaAntigua and
BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire,
Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish
Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo
VerdeCambodiaCameroonCanadaCayman IslandsCentral African
RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo,
Democratic Republic of theCook IslandsCosta
RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican
RepublicEcuadorEgyptEl SalvadorEquatorial
GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe
IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern
TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard
Island and McDonald IslandsHoly SeeHondurasHong
KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of
ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic
People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic
RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall
IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew
CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth
MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State
ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto
RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena,
Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint
Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and
PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint
MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the
South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan
MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United
Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and
TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying
IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited
StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin
Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands



INFORMATION FOR CUSTOMERS IN NEW YORK STATE

At this time, we are unable to process any orders from New York State, outside
of sponsored testing. Please note Familial Variant Testing (FVT) and Targeted
Variant Testing (TVT) are also not available at this time to New York patients,
even following use of a sponsored test. We apologize for any inconvenience this
may cause clinicians or patients in New York State. You can order kits for
sponsored testing (i.e. My Retina Tracker and Resonate Program) below. If you
have any questions please contact: support.us@blueprintgenetics.com.


KIT TYPES

If you wish to order more than 10 kits per type and/or 30 in total, please
contact our customer support team.
Number of Buccal Swab Kits*
Please enter a number from 0 to 10.
Number of Blood Kits*
Please enter a number from 0 to 10.
Number of Exome Buccal Swab Kits*
Please enter a number from 0 to 10.
Number of Exome Blood Kits*
Please enter a number from 0 to 10.
Number of My Retina Tracker Blood Kits*
Please enter a number from 0 to 100.
Number of My Retina Tracker Buccal Swab Kits*
Please enter a number from 0 to 100.
Number of Resonate Program Buccal Swab Kits*
Please enter a number from 0 to 100.
Other Information

Phone

This field is for validation purposes and should be left unchanged.



Notifications







PRIVACY PREFERENCE CENTER

When you visit our website, we store cookies on your browser to collect
information about you, your preferences, or your device in order to make the
site work as you expect it to and to provide a more personalized web experience.
You can choose not to allow certain types of cookies, but that may impact your
experience of our website and the services we are able to offer. Click on the
different category headings to find out more about the different kinds of
cookies we use. If you like, you can change our default settings according to
your preference. However, you cannot opt-out of our First Party Strictly
Necessary Cookies as they are deployed in order to ensure the proper functioning
of our website (such as prompting the cookie banner and remembering your
settings, allowing you to log into your account, and redirecting you when you
log out, etc.). For more information about the cookies we use and to change your
default settings, see below. For more information about cookies generally,
follow this link: More information
Cookie Policy
Allow All


MANAGE COOKIES PREFERENCES

STRICTLY NECESSARY COOKIES

Always Active

These cookies are always active and enable essential website operations and
ensure certain features function properly, such as setting your privacy
preferences, logging-in to your account or filling-out forms. We call these
“strictly necessary cookies”. You cannot switch off these cookies unless you
change your browser settings. You may set your browser to block or alert you
about these cookies, but without them, services that you have asked for cannot
be provided to you. These cookies do not store any personally identifiable
information.

Cookies Details‎

FUNCTIONAL COOKIES

Always Active

These cookies enable our website to provide enhanced functionality and
personalization by remembering your preferences and settings. They may be set by
us or by third-party providers whose services we have added to our website. We
call these “functional cookies.” If you do not allow these cookies, then some or
all of the services may not function properly.

Cookies Details‎

WEBSITE PERFORMANCE COOKIES

Always Active

These cookies allow us and our service providers to count visits and traffic
sources so we can measure and improve the performance of our website. These
cookies help us to know which pages are the most and least popular and help us
understand how visitors move around our website. We call these “performance
cookies.”

Cookies Details‎

PERSONALIZATION AND RECOMMENDATION COOKIES

Always Active

These cookies may be set through our website by our partners to build a profile
of your interests and to provide personalized content and ads on other sites. We
also set first-party personalization and recommendation cookies to help us
promote Blueprint Genetics products and services to health care professionals on
other sites and platforms. They do not directly store identifying information
(such as names or email addresses), but store unique identifiers that identify
to us and our partners a particular visitor’s browser and/or device. If you do
not allow these cookies, you may still see our content and ads on other
platforms, but that will not be based on your visit to our website.

Cookies Details‎
Back Button


PERFORMANCE COOKIES



Search Icon
Filter Icon

Clear
checkbox label label
Apply Cancel
Consent Leg.Interest
checkbox label label
checkbox label label
checkbox label label

 * 
   
   View Cookies
   
    * Name
      cookie name

Reject All Confirm My Choices

blueprintgenetics.com Open in urlscan Pro 162.159.135.42 Public Scan

Form analysis 2 forms found in the DOM

https://blueprintgenetics.com

POST /#gf_1

Text Content

blueprintgenetics.com Open in urlscan Pro
162.159.135.42 Public Scan

Form analysis
2 forms found in the DOM