New Customer Information Form

  • Primary Contact Information

  • Shipping Information

  • Shipping Method & Account

  • Terms

  • 1. I acknowledge that I have read, understand, and will abide by the terms and conditions listed at

    2. Completion of this form is not a guarantee of credit. A separate Credit Application must be submitted to establish a credit account.

    3. By submitting this form, you authorize Paragon Genomics to set up a user account for you in our system.

  • Account Registration

    Choose YES only if you don't have an online user account yet. You can use the account to place orders online.

For early access to our upcoming Respiratory Research Panel combining Influenza A/B and SARS-CoV-2 testing, please visit HERE. Dismiss