Attorney Referral Form — New Day Mobile DNA

1REFERRING ATTORNEY & FIRM INFORMATION

Firm Name

Florida Bar Number

Attorney of Record

Contact Person / Paralegal

Attorney Phone

Attorney Email

Billing Contact Name

Billing Email

Preferred Result Delivery

Attorney Portal Encrypted Email Certified Mail

Billing Arrangement

Per Case Net-30 (Partner) Agency PO Attorney Trust

2CASE & LEGAL INFORMATION

Court Case Number

Circuit Court & County

Presiding Judge

Hearing / Deadline Date

Test Type *

Is This Court-Ordered?

Yes — Court Order Will Be Provided No — Standard Referral

Priority

Standard (2–5 days) Expedited (+$100) Emergency Same-Day (+$150)

⚠ Court-ordered cases will NOT be scheduled until a signed copy of the court order is received. Please email it to newdaydna@aol.com with your case number in the subject line.

3PARTY 1 INFORMATION

Full Legal Name

Date of Birth

Phone Number

Email Address

ID Type

Party 1 Role

Alleged Father Mother Child Other Party

Special Notes (language, accessibility, safety concerns)

4PARTY 2 INFORMATION

Full Legal Name

Date of Birth

Phone Number

Email Address

ID Type

Party 2 Role

Alleged Father Mother Child Other Party

Special Notes

5MINOR CHILDREN (IF APPLICABLE)

Child 1 Full Name

Date of Birth

Relationship to Party

Child 2 Full Name

Date of Birth

Relationship to Party

Child 3 Full Name

Date of Birth

Relationship to Party

Accompanying Guardian Name & Relationship

Minor children must be accompanied by a parent or legal guardian with documentation of guardianship. Guardian must present valid photo ID at time of collection.

6COLLECTION LOGISTICS

Preferred Collection Date

Preferred Time Window

Collection Location (full address)

Location Type

Who Schedules Parties?

New Day contacts parties directly (preferred) Attorney office will coordinate

Additional Notes or Restrictions

7ATTORNEY ACKNOWLEDGMENT

By submitting this form, the referring attorney confirms: (1) Client consent to be tested has been obtained; (2) All information provided is accurate and complete; (3) Any required court order has been or will be provided prior to scheduling; (4) The client has been informed that New Day Mobile DNA will contact them directly to schedule their appointment.

I confirm the above acknowledgment and certify that all information submitted is accurate. (Required)

Attorney Client Referral Form

✓ Referral Submitted Successfully