Hair Mineral Analysis Requisition Form
Please save and print this form, by clicking the arrow in the upper right corner to open the PDF window. Complete the patient information, payment, and insurance portions (areas 4,5 and 6). Then bring the form to your next appointment so that Dr. Craig can complete areas 1, 2 and 3. Please note that the lab cannot process this requisition before Dr. Craig has filled in his information and signature to authorize the test(s).
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