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AYUMETRIX Transparency Logo

Laboratory of the Future - Empowering individuals to take charge of their health and wellness

Get 5 Free Hormone Tests!

Thank You for visiting AYUMETRIX for your testing needs.

When you become a provider and buy your first 5 tests, we'll give you 5 Free Hormone Tests.

We appreciate the opportunity to help healthcare providers better serve their patients. Please complete the information below so we may process your request. All the fields below are required. All kit orders are shipped out to the provider at no cost. Please allow 3 – 5 business days for delivery time. The provider may also request overnight shipping at their own expense. Please feel free to contact us at 1-800-215-8898 to make special shipping arrangements.

How It Works

Just fill out this form and receive your tests when you buy 5 tests from our product list. We make lab testing simple and easy for you and your patients
Practice Information
Test Kits you are Requesting
Receiving Results

To receive results online in PDF format please provide a valid email address. This email address will be used as your username and also to receive notifications when new reports are available. Upon registration, you will receive an email containing a temporary password.

Billing

Provider to Pay: AYUMETRIX will bill provider the special discounted price. The provider will collect payment from patient (check your state regulations). You will be billed monthly for the number of tests that have been performed for your clinic. All billing is charged to the credit card stored on file.

Patient to Pay: Patients pay AYUMETRIX directly.

If you choose “Provider to Pay” option, please send the Autocharge Form separately as a physical signature is required. Account setup will be completed and test kits mailed to you when the signed Autocharge form is received.

Signature

By typing my FULL name below, I indicate that all information is correct and I have read and fully understand my responsibilities for the billing option chosen. I agree to be financially responsible for payment of all charges associated with this account and will inform AYUMEYTRIX if any changes are desired. Also, I acknowledge that only licensed healthcare professionals may order testing for others, and it is my responsibility to understand and abide by any local, state or federal laws that regulate ordering laboratory tests for others.