Refer A Doctor For The SYNTap Test

REFER A doctor

* A physician must prescribe the SYNTap™ Biomarker Test. If you would like us to reach out to your doctor, please complete this form.*

Currently, Amprion offers this test on a self-pay basis. We provide financial assistance programs for those who are eligible. In addition, we’re working hard to establish reimbursement from insurance providers, Medicare, and Medicaid. This test is presently available throughout the US, except Maryland, New York, and Rhode Island.

I’d like Amprion to Contact My Doctor

First Name

Last Name

Phone

Please send information about Amprion and the
SYNTap Biomarker Test to my physician:

Physician First Name

Physician Last Name

Phone

I authorize Amprion to tell my physician that I am interested in the SYNTap Test and send information about this test to my doctor by unencrypted email. In addition, I grant Amprion permission to discuss the information by telephone and other means with my doctor. I have read and agree to the Privacy Policy

Full Disclosure: Amprion has measures in place to protect your privacy, including administrative, technical, and physical safeguards. While Amprion has security measures to protect against the loss, misuse, or alteration of information, it is not possible to guarantee the safety of the information transmitted on the Internet. Therefore, you should use safeguards on the computers you use to access our website to help keep your information secure.

REFER A doctor

I’d like Amprion to Contact My Doctor

Revolutionizing Brain Disease Diagnosis