Client Forms

New Clients

If this is your first time doing a hair analysis with me, please take a few minutes to complete the following forms:

New Client Intake Form (about 15 minutes)
Mineral Balancing Academy Membership Agreement (sign and date)
NOTE: The Private Membership Agreement protects our right to freedom of choice regarding health care decisions and alternative therapies.

Retest Form
Please complete this form if you have just ordered a retest hair analysis.

Program Support Form
Please complete this form for help with symptoms that arise while following a mineral balancing program.

Uncover and address your mineral imbalances with Hair Mineral Analysis

Do you have unexplained or mysterious health problems, but are only being offered drugs and remedies to manage the symptoms?

At Brezinski Nutrition, we can help you uncover and address the cause of your health problems, so you can regain your health for good. Click here to learn more about joining our practice.

Located in Northern Virginia and serving clients throughout the USA and Canada.