paperwork

Please print and complete this 7 page form for your appointment.  

 

You may also bring any supplements and medicine you are taking, along with a small sample

(2 oz) of your tap water taken first thing in AM (glass container is best) . 

 

These can be tested for compatibility and/or stress during the bio-resonance testing process with your system.

 

**IF THE FORM DOES NOT APPEAR BELOW PLEASE HIT THE REFRESH BUTTON.