MosaicDX Case Study Submission

Thank you for taking the time to share your case study!

By sharing your unique approach and insights, you’re not only helping other practitioners learn and grow but also showcasing your expertise in a way that will inspire patients to ask how you’ve helped others just like them. This JotForm is designed for you to easily provide the content—we’ll take it from there to create a beautiful, one-page case study. It’s that simple! You provide the info, and we handle the final creative to feature in your office and spotlight your success on our website. For any questions, please reach out to Kristina at kcripe@mosaicdx.com or call (913) 237-5355.
We look forward to celebrating your story and its impact on the field! Please note that this form is not HIPAA-protected; therefore, please do not include any identifying patient information. To ensure privacy, only use the patient's first name or an alias.

For added privacy, we will also include the following note in the case study: Note: This patient’s name is not real and has been altered to protect their identity.
Your Name*

First NameLast Name
Certifications (i.e. MD, ND, DC, DO, APRN)*
Type a question
Who was your patient, and what brought them in?*

Please share a brief description of the patient’s background and main health concerns. What symptoms were they experiencing that led you to consider testing? Ex. Patient is a 42-year-old female who presented with chronic fatigue, digestive discomfort, and frequent headaches. She reported years of...0/350
What testing did you use, and why? What key insights did the testing reveal?*

Describe the Mosaic Diagnostics test(s) you selected for this patient and outline the key insights gained. Why did you choose these specific tests, and were there any surprising patterns or critical markers that shaped your approach?0/350
What steps did you take following the results?*

Share any treatments, lifestyle changes, or supplements you recommended based on the test findings. How did these align with the patient’s needs?0/350
How did the patient respond over time?*

Describe the patient’s progress. Did symptoms improve, and if so, how quickly? Were there specific outcomes you could attribute to the interventions?0/350
Please categorize your study:
Would you be open to sharing a non-identifiable data snippet from a test report that highlights specific results or markers that guided your care plan? You’ll have the opportunity to review and approve the case before publication. (This is completely optional.)

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If it’s easier, you can provide the report number, and our team can retrieve the data and highlight it for the case study.
Please list the test requisition number/s and the key markers of note.
How do you prefer to receive your final case study—for your office, to share with patients, or to promote on your social channels? I would like...

a framed copy for my office.a digital file.a co-branded art card for promotion in social channels.an email template that you can share with your key referral partners.MosaicDX to Print out letters along with my case study and cover the cost to mail to my key referral base. Note: for this option the MosaicDX team would need your office to supply your key referral partners in a mail merge file.
Any additional notes or comments?

Feel free to add any final thoughts on the testing process, patient experience, or other relevant details that could help other practitioners.0/350
We’d love to put a face to your amazing work!

If you’d like, please upload a headshot we can use along with your case study. A friendly smile helps us share your story and connect with others!
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Have a website where we can learn more about you?
Share the link here if you’d like!
By selecting "YES," you authorize Mosaic Diagnostics and its subsidiaries to use and publicly display your case study, including your first and last name, professional title, image, and likeness, across our marketing channels. This may include, but is not limited to, Mosaic Diagnostics’ website, email communications, social media, advertisements, sales materials, and other promotional platforms.*
We are committed to respecting your privacy and will ensure that all other uses of your case study align with the Mosaic Diagnostics Notice of Privacy Practices. Your contribution helps us share valuable insights with the medical community, supporting practitioners in improving patient outcomes and advancing the field.Thank you for allowing us to highlight your story and the success of Mosaic Diagnostics testing.
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Thank you for taking the time to share your case study!

We look forward to celebrating your story and its impact on the field! Please note that this form is not HIPAA-protected; therefore, please do not include any identifying patient information. To ensure privacy, only use the patient's first name or an alias.