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Request Form For Neurotransmitter Testing


To request neurotransmitter testing and telephone consultation to discuss test results and neurotransmitter optimization strategies,
please fill out the form below.

You'll receive an email reply from us within 24 hours with an apointment date, time, recommendation for the neurotransmitter test
profile that addresses your health concerns most specifically and further instructions on how to proceed.

At this time we can only provide neurotransmitter testing to our U.S. clientele.

Name (First & Last)


Age


Telephone Number (please include area code / country code if not calling from the U.S.)


Time Zone


City


State/Province


Country


E-Mail Address


Confirm E-Mail Address


Select Length of Consultation


What are your health concerns? Please be concise.


What medications if any are you presently using.






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Neuro Health Profile with 30 minute Telephone Consultation
Urine analysis: Epinephrine, Norepinephrine, Dopamine, Serotonin, GABA, PEA
Indicated for: General neurotransmitter assessment, Mood, Mental focus
charge: $288.00

Neuro Focus Profile with 30 minute Telephone Consultation
Urine analysis: Epinephrine, Norepinephrine, Dopamine, Serotonin, GABA, PEA, Histamine
Indicated for: ADD / ADHD, Autism, Mood, Mental focus
charge: $337.00

Insomnia Profile with 30 minute Telephone Consultation
Urine & saliva analysis: Epinephrine (urine), Norepinephrine (urine), Serotonin (urine), Glycine (urine), GABA (urine), Glutamate (urine), PEA (urine), Creatine (urine), Cortisol (saliva), Melatonin (saliva)

Indicated for: Insomnia and Sleep disturbances
charge: $379.00

Please do not proceed with payment until you have received an appointment from us.
If you'd like to have a neurotransmitter profile conducted, please fill out and submit the request form above this table.
You'll receive an appointment date from us, usually within 24 hours after submitting your request.
Once we've agreed upon a date, you'll pay for the test & consultation and will be sent a postage paid collection kit with instructions.
Based on the lab's turn-around time, your phone appointment will be scheduled for three weeks after the receipt of your payment.
Do to the inherent limitations of our shopping cart program, California based clients will automatically be charged sales tax for their test & consultation.
This erroneous charge will be credited back to your account on the same day that your payment is made.


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We specialize in candida related conditions and digestive disorders: candida albicans, candidiasis, chronic fatigue, fibromyalgia, fungal infection, thrush, systemic yeast,
vaginal yeast infection and other common types of yeast infection, acid reflux, GERD, H pylori, helicobacter pylori, intestinal yeast overgrowth, leaky gut syndrome and stomach ulcer.

The information contained in these pages is not intended to take the place of your health
professional's advice. It is derived from our clinical experience and may shed light on your
health complaints. In case of serious ailments which may not respond favorably, please
seek the counsel of a qualified health professional.

This site is financially supported exclusively by David B. Schlesinger, L.Ac.




We subscribe to the HONcode principles
of the Health On the Net Foundation


This site was last updated March 30, 2008

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