Test Details

Lab Company: Precision Analytical
Sample Type: Saliva
Collection Location: At Home

The DUTCH Cortisol Awakening Response (CAR) test measures hormones to analyze a patient’s stress response and adrenal function.

Key Details

Collect your sample on a day in which you did not have significant sleep disturbances.
If you are taking hormones, you may have special timing requirements.
Avoid alcohol, caffeine, and exercise the night before collection and on the collection day.
Do not floss the day of collection.
Do not brush your teeth or consume morning food and drink until after collection 3.
Freeze all samples within 12 hours of collection. Keep frozen until shipping.
You will use 5/6 saliva tubes.
Send samples back to the lab as soon as possible after collection.
You MUST send the completed test requisition form and waiver (NY & RI patients only) back to the lab with your samples. Failure to send these forms with your samples may result in a recollection.

Collect your sample on a day in which you did not have significant sleep disturbances.
Avoid hydrocortisone cream the day prior to collection.
- This applies to both the patient and anyone else in the household.
If you take glucocortisoids, please consult your healthcare provider regarding timing.
If you take oral hydrocortisone, see video instructions here.
Avoid caffeine, alcohol, and exercise the night before and the day of collection.
Do not floss your teeth until all samples are collected.
Do not brush your teeth until after collections 3 and 5.
Do not eat until after collections 3 and 4.
Freeze all samples within 12 hours of collection. Keep them in the freezer until ready to ship.
Send samples back to the lab as soon as possible.
The three morning samples MUST BE collected on the same day.
If you miss a collection, collect it at the appropriate time the following day.
DO NOT collect your sample while traveling for short periods of time.

Collection 1: Collect immediately upon waking, before eating or drinking.
1. Complete within 5 minutes of waking.
2. Set a timer for collections 2 and 3.
3. Do NOT brush or floss your teeth, eat, or participate in vigorous activity.
Collection 2: Collect 30 minutes after collection 1.
1. Do NOT brush or floss your teeth, eat, or participate in vigorous activity.
Collection 3: Collect 60 minutes after collection 1.
1. You can now eat and brush your teeth.
Collection 4: Collect between 4:00 pm and 5:00 pm (before your evening meal).
1. Do NOT brush your teeth.
Collection 5: Collect between 10:00 pm and 12:00 am (or at bedtime).
1. Rinse your mouth with water 10 minutes prior to collection.
2. You can now brush your teeth.

Set the saliva collection device, requisition form, and pen next to your bed the night prior to collection.
Collect the first sample immediately upon waking, before getting out of bed.
Remove the tube cap.
Place the cotton swab from the collection device in your mouth.
1. Touch the swab as little as possible with your hands.
Leave the swab in your mouth until fully saturated. Do not leave it in longer than 5 minutes.
1. Lightly chewing on the swab may help stimulate saliva flow.
Once the swab is saturated, place the swab back into the same tube as you found it.
1. Do not remove the inner tube.
2. Do not spit into the tube.
Complete all information on the tube label.
Freeze the saliva sample until ready to ship.
Set a timer for the second and third collections after you have completed the first.
Move to a well-lit location after the first saliva collection.
Repeat steps 3-8 for each collection.
COMPLETE THE TEST REQUISITION FORM.
1. Instructions on how to fill out your requisition can be found HERE.
2. If you live in New York or Rhode Island, please also complete the included waiver (instructions HERE).
3. Failure to complete and send the test requisition form may result in a sample recollection.

Your kit has been prepaid. You DO NOT need to pay anything extra.
Instructions on how to fill out your requisition can be found here.
- Since you pre-paid for your tests, you do not need to fill in the payment information on any of these forms.
If you live in New York or Rhode Island, please also complete the included waiver (instructions HERE) and send it to the lab with your samples.

To prepare your samples for shipping,
- Place the frozen saliva samples inside the test kit box.
- Place the completed test requisition form inside the test kit box.
- Place the completed waiver (NY & RI patients only) into the test kit box.
- Place the test kit box inside the return envelope.
- Attach the provided, prepaid label or postage.
Please ship ALL tests as soon as possible after completion.
- If you have to wait to ship your samples, please place the plastic bag containing the samples in the freezer after they have dried.
Make a note of the tracking number so that you can track your sample back to the lab.

Results should be released to your provider 7-10 business days after samples are received at the lab. We cannot guarantee processing time.
Your provider will notify you when your results are in and schedule a follow-up appointment for you to review them together.

For general questions, email Rupa Health at support@rupahealth.com. For test-specific questions, contact Precision Analytical by calling 503-687-2050 or chatting with support.