TEST FORM

First name *

Last name *

Email address *

Confirm Email address *

What can we help you with? *

What state/territory do you reside in? *

We don't always hold details for physicians in every state/territory, would there be another state/territory you are willing/able to travel to? If so, please select one below.

What is your city or town? *

What are your main symptoms? *

Why do you suspect you have Lyme disease? *

Please outline your enquiry. *

What type of IGeneX test kits do you require? *

Blood collection kit

Urine collection kit

Blood AND Urine collection kits

How many of EACH IGeneX kit do you require? *

eg. If you require two blood kits and two urine kits - type 2

How many ArminLabs kits do you require? *

Please enter LDAA member discount code *

To receive a valid code, you must first apply to become an LDAA member at the following link: https://www.lymedisease.org.au/help/membership-application-form/
(Or navigate to the LDAA Homepage -> Donate -> Membership Application Form)
An ArminLabs discount code will be emailed to you once you have completed the membership application.

How many brochures do you require? *

Which DVD would you like to borrow and for what purpose? *

Under Our Skin 1 - For personal use

Under Our Skin 2 - Emergence - For personal use

What is your postal address? *

What is your suburb? *

What is your state? *

What is your postcode? *

What is your telephone number? *

Fundraising and Awareness Events

If you would like to fundraise for the LDAA and/or raise awareness of Lyme disease in Australia then please visit our events page. From our events page you can register, order and download merchandise for your event.

See all planned events, access event tools and register your event after the link here!

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Fundraising and Awareness Events

Recent Posts

Tuesday Lymie Lunches

Lyme Warrior Boxes