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)
Nutritional 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.

Existing Clients

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 nutritional balancing program.

Hair Sampling Resources

Hair Sampling Instructions (PDF)
How To Cut a Sample For Medium to Long Hair (Video)
How to Cut a Hair Sample on Short Hair (Video)
How to Cut a RETEST Sample on Medium to Long Hair (Video)

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.

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