Order Form - Home Breath Test Kits

Please add using format: dd/mm/yyyy
Please include area code, eg. 03 if this is a landline phone
Please include your Area Code. Example the Area code for Melbourne would be 03
For paediatric patients, sugar dose need to be adjusted according to bodyweight

A Gastrolab staff member will contact you on your contact number to arrange payment for the Breath Test Kits once you have placed your order.


Patient's Postal Address - For Delivery


Breath Test Kits Required

Each test selected below costs $110.
The minimum cost of any order is $240 as Lactulose is included as a compulsory control test.
(Note: This is an out-of-pocket expense as there is no Medicare Rebate available for these tests).

SELECT FROM:

FODMAP Malabsorption

Small Intestinal Bacterial Overgrowth


Referral Source

(A Doctor's referral is not required for these tests)
Please complete details below
Please include Area Code: e.g: 03
Please include Area Code: e.g: 03

How did you find out about us?



Contact Us

Phone: 1300 624 771
Fax: (03) 9331 4198
Email: enquiries@gastrolab.com.au

Head Office:
Level 1
456 Lower Heidelberg Road
Heidelberg VIC 3084

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Breath Testing - Sydney (NSW)

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Breath Testing - Perth (WA)

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Breath Testing - Adelaide (SA)