Order MindX Products

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For Consumers/Patients

Life x Mind App

For Clinicians

Clinician Info

First Name*

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Last Name*

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Credentials*

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Practice/Organization Name*

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NPI#*

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Specialty*

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How did you hear about us?*

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Address Info

Address 1

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Address 2

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City

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State

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Postal Code

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Email Address*

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Email Address (confirm)*

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Phone Number*

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FAX Number

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Order

Please note: ordering clinicians must be able to order diagnostic laboratory testing to receive our testing kits.

Number of MindX Blood Test Kits

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Number of SXPrevent Digital Tests

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Please send me product updates and information about MindX Sciences.

I consent to MindX Sciences storing the submitted data and contacting me.