For any first-time test purchaser, this initial qualification form will need to be completed in full in order to provide evidence of a person’s eligibility to use the tests. You will need to complete the requested information on this form, carefully read the terms, sign it, and then return it to Riverside Insights via fax, mail, or email.  
  • Email forms to be sent here: 
  • Postal forms to be sent here: Customer Services, Riverside Insights, One Pierce Place, Suite 900W, Itasca, IL 60143.