The relative ratios of minerals in the hair can give an indication of a person’s individual metabolic makeup, plus the level of oxidative energy. High mineral values can indicate excessive consumption of one or more minerals, mineral storage or excessive usage. From this information, you can get strong indications of metabolic function, energy production, glandular balance and overall body efficiency. Patterns in the hair can show blood sugar stability, stress response and recovery, detoxification speed, sensitivities to the environment, and interferences to healthy metabolic function. In combination with other appropriate testing in a functional setting, hair mineral analysis can be a valuable asset in anyone’s health program.
HMA can identify: • Mineral deficiencies, excesses and imbalances • Metabolic balance • Sugar handling capabilities • Stress response and recovery • Endocrine and digestive patterns • Toxic metal presence • Inflammatory patterns
Address:___________________________________________________________________ City:______________________________________________________________________ State:______________ Zip:_______________ Phone: (_____)___________________________________________ Fax: ______________________________________________________ Email Address:________________________________________________________________ (if email address is provided, we will email results)
SEND RESULTS TO: (if different than above) Address:___________________________________________________________________ City:______________________________________________________________________ State:______________ Zip:_______________
Submitted By:_________________________________________________________________
INFORMATION: Select One: q New Test
q Re-Test, Previous test date:____________ Age:_______________________ Gender: q Male q Female
FEMALES ONLY
Pregnant:
Menopause: Height:_____________________ Weight:______________________________ Ethnic Origin: Natural Hair Color: Type of Sample:
n
Nor do two people have exactly the same metabolic needs.
Name: _____________________________________________________________________
Sar Andah erso
No two people have exactly the same fingerprint.
HOW TO SEND IN A SAMPLE
Hair Mineral Analysis Submittal Form
q Caucasian q Hispanic q Blonde q Brown q Scalp qPubic
q African-Am q Asian q Black q Red q Auxilary (underarm)
q Yes q Pre-
q No q Post-
q Other q Grey
Normal levels and interpretations are based upon hair obtained from several areas of the occipital region of the scalp. Samples should not be obtained from hair that was permed, colored or chemically treated within the past eight (8) weeks. Shampoo and other hair products used:______________________________________________________________________________________________ _________________________________________________________________________________________________________________________________ Health Concerns or Chronic Problems:_______________________________________________________________________________________________ _________________________________________________________________________________________________________________________________ Current Medications: (or any used in last 4 months)____________________________________________________________________________________
• Cut the hair as close to the skin as possible. • Length of hair should not exceed 2 inches. • Amount of hair needed for an accurate analysis is approximately one tablespoon. • Hair should not be sampled from other parts of the body, as it may not reflect an accurate representation of mineral balances. • Put the hair sample in plastic pouch labeled with your name. • Place form and plastic pouch in postage paid envelope and mail back to Uckele. Samples should not be obtained from hair that was permed, colored or chemically treated within the past eight (8) weeks.
_________________________________________________________________________________________________________________________________
Payment ($249.95 per test / 3+ $229.95 ea.): q Web Order Prepaid q Check or M.O. Enclosed
q Credit Card (Visa, MC, AmEx, Discover accepted)
Credit Card #:___________________________________________________________________ Exp. Date:______________________________ CVV Code:____________________________ Signature:______________________________________________________________________
Place form and plastic pouch in postage paid envelope and mail back to Uckele. Allow up to 4 weeks for the results that will include a graph, recommendation/summary page, and a phone consultation with a nutritionist explaining the results.
Hair Mineral Analysis (HMA) information is for self-educational and informational purposes only and in no way is intended as medical counseling or medical advice concerning any medical condition, disorder or disease. None of the services, information, statements or products discussed have been evaluated by the FDA and are not intended to diagnose, treat, cure or prevent any disease. Always seek professional medical advice from your physician or other qualified health care provider with any questions you may have regarding a medical condition.