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Initial General Information

If you are unable to submit the form electronically, you can print it out:

Initial General Information Sheet: Page 1 | Page 2 | Page 3 | Page 4

Fill in your information, scan, and email back to us at HairAnalysis@GoHealthyNext.com. You may also fax it to us without a cover sheet to (866) 370-7199.  We do not accept printed and mailed copies of the forms.