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).


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)

Breath Testing - Canberra (ACT)

Breath Testing - Perth (WA)

Breath Testing - Brisbane (QLD)

Breath Testing - Adelaide (SA)