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Compare FORM bloodwork packages: Essential, Pro, Elite Protocol and Ultra

Compare

The full comparison.

Same nurse home draw, same ISO 15189 lab, same expert-reviewed report. Difference is depth — how many biomarkers, and which systems we cover.

Essential blood test vial
Essential
20 biomarkers
Rp 3.3M≈ $206
Pay in 3 at checkout

Built for first-time testers who want to stop wondering.

See full panel →
Pro blood test vial
Pro
44 biomarkers
Rp 9.89M≈ $618
Pay in 3 at checkout

Built for men pushing hard who want the full systems picture.

See full panel →
Elite Protocol blood test vialMost popular
Elite Protocol
55 biomarkers
Rp 17.59M≈ $1,100
Pay in 3 at checkout

Built for men who want the deepest hormone & metabolic picture.

See full panel →
Ultra blood test vial
Ultra
73 biomarkers
Rp 31.35M≈ $1,959
Pay in 3 at checkout

Built for men who want zero blind spots and comprehensive health optimization.

See full panel →
Essential
Built for first-time testers who want to stop wondering.
Rp 3.3M≈ $206 USD

Eligible customers can pay in 3 monthly installments at checkout.

  • Biomarkers20
  • Total + Free Testosterone
  • Cortisol
  • Full thyroid (TSH/T3/T4)
  • Lipids + ApoB
  • hs-CRP + Homocysteine
  • Liver + Kidney panels
  • LH, FSH, Estradiol, Prolactin
  • Fasting Insulin + HbA1c
  • PSA cancer marker
  • Micronutrients (Vit D, B12, Mg, Zn)
  • Nurse home draw in Bali
  • Expert-reviewed PDF report
  • Personalised 12-week protocol
  • Reimbursement docs
  • 2× 1-hour MD consultations
Pro
Built for men pushing hard who want the full systems picture.
Rp 9.89M≈ $618 USD

Eligible customers can pay in 3 monthly installments at checkout.

  • Biomarkers44
  • Total + Free Testosterone
  • Cortisol
  • Full thyroid (TSH/T3/T4)
  • Lipids + ApoBBasic
  • hs-CRP + Homocysteine
  • Liver + Kidney panels
  • LH, FSH, Estradiol, Prolactin
  • Fasting Insulin + HbA1c
  • PSA cancer marker
  • Micronutrients (Vit D, B12, Mg, Zn)
  • Nurse home draw in Bali
  • Expert-reviewed PDF report
  • Personalised 12-week protocol
  • Reimbursement docs
  • 2× 1-hour MD consultations
Elite Protocol
Built for men who want the deepest hormone & metabolic picture.
Most popular
Rp 17.59M≈ $1,100 USD

Eligible customers can pay in 3 monthly installments at checkout.

  • Biomarkers55
  • Total + Free Testosterone
  • Cortisol
  • Full thyroid (TSH/T3/T4)
  • Lipids + ApoB
  • hs-CRP + Homocysteine
  • Liver + Kidney panels
  • LH, FSH, Estradiol, Prolactin
  • Fasting Insulin + HbA1c
  • PSA cancer marker
  • Micronutrients (Vit D, B12, Mg, Zn)
  • Nurse home draw in Bali
  • Expert-reviewed PDF report
  • Personalised 12-week protocol
  • Reimbursement docs
  • 2× 1-hour MD consultations
Ultra
Built for men who want zero blind spots and comprehensive health optimization.
Rp 31.35M≈ $1,959 USD

Eligible customers can pay in 3 monthly installments at checkout.

  • Biomarkers73
  • Total + Free Testosterone
  • Cortisol
  • Full thyroid (TSH/T3/T4)
  • Lipids + ApoB
  • hs-CRP + Homocysteine
  • Liver + Kidney panels
  • LH, FSH, Estradiol, Prolactin
  • Fasting Insulin + HbA1c
  • PSA cancer marker
  • Micronutrients (Vit D, B12, Mg, Zn)
  • Nurse home draw in Bali
  • Expert-reviewed PDF report
  • Personalised 12-week protocol
  • Reimbursement docs
  • 2× 1-hour MD consultations

Customers average ~95% reimbursement from international insurance (Cigna, Foyer Global Health, Genki, XCover, AXA). Itemised receipts + ICD-10 codes included as standard.