The forms listed in this menu are for Mineral Balancing clients. If you are not a client, please submit your question on my “contact us” page.
Info on the Referral and Discount Program at the bottom of this page.
Here is information regarding how to use each of the forms. You can click on any of the links to open the form you need.
- CLIENT QUESTION FORM – Most health questions you encounter while following the program; healing reactions, or other personal issues may be submitted using the Client Question Form. This will give me basic information to review when responding to your question. Simply questions can be submitted through email but I may ask you to use this form for more complex questions. Use email to ask questions about procedures, your report or other protocols.
- NEW CLIENT GENERAL INFORMATION FORM – This form can be completed by NEW clients who have paid for a Hair Analysis/Nutritional Balancing Program and are entering the program. The form is also mailed with you hair sample collection kit and can be completed and returned via mail, or scanned and emailed to me. Pick whatever is easiest for you – scan, email or on-line. The form must be returned for your program to be processed.
- RETURNING CLIENT RETEST INFORMATION FORM – Returning clients who are ordering a retest need to complete this form. This form is also mailed with you hair sample collection kit and can be completed and returned via mail, or scanned and emailed to me. Pick whatever is easiest for you – scan, email or on-line. The form must be returned for your program to be processed.
- HAIR ANALYSIS CLIENT COMPARISON REPORT – This is for returning clients who have had three or more Hair Analysis Reports and want to compare results for valuable and detailed information that can help move you to the next level of healing and give you a deeper understanding of your report and program.
- BIORESONANCE INTAKE FORM – Complete when you purchase your Bioresonance package. This only needs to be submitted once!
Referral and Discount Programs
Holistic Wellness from Within knows that word of mouth is the best source for referrals! I also recognize that families deserve discounts and that some of you have truly strapped circumstances that may allow you to apply for the Hardship Program. I want to reward clients for referring new clients to the Mineral Balancing program by offering rewards money that you can use for your follow up test, offer family discounts, and offer some help for those who really need it. Details on these programs are here:
- New referrals must order their test and place one order, (their first order), from Endomet for the basic supplements that are part of their program to qualify as a new referral.
- For each qualified referral, you will receive a $10 credit.
- The credit is good and may be applied to your follow up test, (retest), if you retest in the time frame recommended on your last program design.
- You can accumulate credits for every qualified referral – up to $50 per Retest. Any additional reward money will be “saved” and may be applied on future retests.
- Reward credits cannot be transferred to other clients.
- Upon referring a client, an email needs to be sent to me so I can update my records and track the client’s activity and track your credits.
- You will be notified when you receive reward money/credits.
- All rewards may only be used as credits on Retests and is not available to be received as cash.
FAMILY DISCOUNT PROGRAM
- If you have a “nuclear” family of 3 or more, you are eligible to receive a discount of $10 off each Hair Analysis that is ordered.
- A nuclear family consists of one or more parents, and children 18 and under, who live in the same household.
- Other family members – sisters, aunts, parents etc. who are not part of your nuclear family do not qualify for the Family Discount Program. However, extended family members do qualify as referrals! (See Referral Rewards program info above).
- To receive the Family Discount, all tests must be ordered at the same time.
- Invoices for the tests will be sent via Paypal for the family discounted – $10 off each test.