I request that Melissa Navarro/Julien Griffault perform a nutritional evaluation and set up a diet, supplement, detoxification and lifestyle program for the purpose of enhancing health and improving well-being. I understand that all testing, techniques and supplements are recommended/provided for the purpose of reducing stress and balancing body chemistry. None of the services/products recommended or provided are intended as diagnosis, prevention, treatment or prescription for any mental or physical disease, and are not intended as substitute for regular medical care.
I authorize Analytical Research Labs of Phoenix, Arizona to perform a hair mineral analysis of my hair sample (if given). I further authorize the sharing of my personal information, analysis and/or other testing results with Dr. Lawrence Wilson, and/or any other advanced health practitioner Melissa Navarro/Julien Griffault may consult for the purpose of designing my nutritional program.