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Intake - Epigenetic Hair Follicle Analysis: At-Home Kit for ages 14-Adult
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Do you reside in New York State?
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Strict Adherence Notice
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We do not ship to New York State due to the state's legal restrictions
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💼 First & Last Name
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Email Address
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📞Phone Number
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Shipping Address
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Date of Birth
(*required by lab to run scan)
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Gender at Birth
(*required by lab to run scan)
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⚧ Gender at Birth (*required by lab to run scan)
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Female
B
Male
How did you find us / or hear about us?
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What is your primary purpose of getting the hair analysis?
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Do you have a health condition currently being treated by a provider? If so, list condition(s).
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Describe any recent illnesses, emotional stressors, or out of the ordinary health experiences (within the last 90 days)
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Have you had any travel in the las 90 days?
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List any current medications and/or supplements
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Do you have any allergies or food sensitivities? If so, list them below
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Hawaii & Alaska Surcharge -
If you are located in Hawaii or Alaska, a $75 shipping surcharge applies.
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