Returning Client RETEST Information Form

This form is for RETURNING clients only. If you have paid for your hair analysis kit, you will receive a hard copy of this form in the mail. You can either mail it back to me OR fill this form out on line. If you are a NEW client, please complete the New Client Form on my contact page. ALL * questions must be completed for the form to be submitted. Write none or N/A if needed. You will receive a message when the form is submitted. If you are not a client, leave a message for me by clicking on the "contact us" tab on my homepage.