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Healthcare Professionals Order Form

GET THE MOST COMPLETE PICTURE

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Trio-Smart is a doctor-ordered test. Prescribers can order Trio-Smart by following the instructions below. Patients interested in Trio-Smart can order through our online prescriber service or work with their provider.

1

Complete the test order form below 

Alternatively, you can fax (818-301-3222) or email (support@triosmartbreath.com) a signed requisition form. 

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Requisition Form

2

Patient receives a kit, collects breath samples and ships the samples to the lab

A pre-paid shipping label is included with each kit. Our support staff is on hand to help patients with any sample collection issues. (Our support staff cannot provide medical advice.)

3

Results are delivered to you within seven days of receiving the sample

Results can be delivered via secure email or fax. You can access the Gemelli Results Portal anytime here.

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Collection Instructions

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Sample Results Report

Instructions
Order
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Complete the form below to place your order.

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