Checkout – Additional Information

Additional Fields

Patient First Name *

Patient Last Name *

Country *

Postcode *

Patient Address Line 1 *

Patient Address Line 2 *

Patient Address Line 3 (optional)

Town/City *

Patient Date of Birth *

Sex * Male Female

Do you need a test collection kit sent? (If you are drawing blood at a center who holds kits, please select no) * Yes No

Order Notes (optional)

Patient Email *

Patient Contact Number *

By ticking this box you agree to and accept the terms and conditions of sale and understand that this order is to be completed within 90 days from this order date. You also agree that you are aware of the relevant conditions to the FunctionalDX test. *

Please note it is the responsibility of the ordering practitioner that their client is made aware of any relevant conditions to the FunctionalDX test.

Important Notice

Please ensure your test requisition form is printed, completed and signed, and returned inside the FDX kits box to avoid incurring a £30 administration fee, which will require settling before results are released. A requisition form is sent to both your email address and to Phil Richards Nutrition.

Tests

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Checkout – Additional Information

Additional Fields

Important Notice

Tests

Cart

My Account / Login

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Additional Fields

Important Notice