Autoimmune Brain Panel™ Order Form

Autoimmune Brain Panel™ Order Form

(FORMERLY KNOWN AS THE CUNNINGHAM PANEL™)

Please download and fill in the Autoimmune Brain Panel™ Order form and send with your blood sample.

It is vital that the order form is signed either by the patient or on behalf of the patient by the practitioner, as consent is required.

For further information on how to prepare the sample for sending and to make the payment, please call +44 (0) 3331 210 305 or email info@aonm.org.

Download Order Form