At-Home Gut and Brain Health Test

Participant Information

What is your full name?

What is your email address?

What is your phone number?

Please enter a 10-digit US mobile number. We will text a code to it to confirm your submission.

What city and state do you live in?

Please enter your city and state (e.g., Phoenix, AZ).

Are you open to hearing about other gut and brain health resources or services from Autism Diagnostics Lab in the future?

Yes No

What types of studies would you be interested in?

List comma separated keywords

General Eligibility

Are you a parent or caregiver of a child who is 2 years old or older?

Yes No

Do you live in the United States?

Yes No

Is your family exploring this in connection with an autism diagnosis or developmental concerns?

Yes We're not sure, still exploring Prefer not to say

Are you interested in understanding your child's gut and brain health and development?

Yes No

The Gut and Brain Health Test is a self-pay kit, it is not billed to insurance. Are you open to purchasing it out of pocket?

Yes No

The test is done at home, you collect a urine sample from your child and mail it in using the prepaid materials included in the kit. Are you comfortable doing that?

Yes No

How did you hear about the Gut and Brain Health Test?

Social media (Facebook or Instagram) A friend or family member An online search A healthcare provider An online community or support group Other