Healthcare Professionals Order Form
GET THE MOST COMPLETE PICTURE
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.
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.
Collection Instructions
Sample Results Report
Complete the form below to place your order.
