KRAS-variant Order – Post Survey Step 1 of 11 9% Welcome!Thank you for completing the survey! If this is your first MiraKind study, your next step is to click "Get Started" below to order a kit to collect your DNA. During this ordering process you will have the option to order your KRAS-variant results. You can learn more about why you may want them and how much they cost here. Note if you order results, they must be sent to a physician. If you have already been a part of a MiraKind study and previously sent in your sample, you're done! However, if you want to order your KRAS-variant results, please order them here. If you have any questions, email us at info@mirakind.org. Consent for Research StudyClick here to review the research consent document. I have read this form and decided that I will participate in the study described above. Its general purposes, the particulars of involvement and possible hazards and inconveniences have been explained to my satisfaction. I understand I will be emailed a PDF copy of the consent document. I agree that I have read and accept the above terms* I agree KRAS-variant ResultsWould you like to know your KRAS-variant results?* No, I only want to submit my DNA for research - $0 Yes - $129 Yes, however I need financial assistance Financially Assisted KRAS-variant Test* $90 $75 $50 $30 Other - note minimum is $30 Custom Amount ~ $30 minimum* KRAS-variant Test Price: KRAS-variant Test Price: $0.00 Your Total will be $0.00 Please explain why you need financial assistance at this time.* Reason you want your KRAS-variant results Reason(s) for testing, check all that apply:* Personal history of cancer Family history of cancer Personal or family history of more than one cancer in an individual (multiple primary cancer) To help guide the decision regarding hormone replacement therapy Current cancer diagnosis for information to help guide the decision on treatment choice Before you order, please note that a physician must deliver your test results. You have the option of using your own or you may select one of our partners that can connect you with a physician. Our partner, Gennev, has OB/GYNs that can discuss your results and to answer any questions you may have. (You would pay Gennev separately for this service). Physician (Note: A physician must be involved in the reporting of this test. If you need a physician, please select one of our partners)* I have a physician Gennev - Yes, I understand there is a separate service fee I'd like to release my results to both Gennev and my physician Physician InformationYour Physician's Name* First Last Your Physician's Phone Number* Your Physician's Fax Number* Your Physician's Email Address Personal InformationName* First Last Email* Enter Email Confirm Email Phone Number* Your Birth Date*MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Shipping InformationYour current SHIPPING Address*We currently ship to the Unites States. If you need a test kit shipped to another country, please contact us at info@miradx.com. Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code MiraKind is an independent nonprofit that runs studies to answer questions about cancer for individuals and their families with novel germline mutations. I would like to be signed up for the MiraKind newsletter to keep up to date on studies and results from studies.* Yes, please subscribe me No thanks I understand my individual results and information will never be shared without my permission. I give MiraKind consent to release my results to my chosen physician.* I agree Total $0.00 Credit Card*Card Details Cardholder Name Almost done! Please click "Send" only ONE TIME to complete your order. Give the system a minute or so to process your order and then you will be redirected to a success page. Thank you!