DIRECTIONS
IfyouorderedtheRegenixJumpStartKit,pleasecompletethisquestionnairebefore
startingthetreatment.Itwilltakeapproximately3weekstoreceiveyourresultsfrom
thisanalysis.Youwillreceiveadetailedletterexplaininganyproblemsthatwere
identifiedalongwithmicrophotographs*ofyourhairsamples.
*Thenumberofmicrophotographsdependsonthenumberofusablehairsamplesreceived.
Step1-Filloutthequestionnaire-pleasePRINTclearly.
Step2-TaketheLooseHairSamples
Whentakinghairsamples,doitrightbeforeyoutakeashower;thatway,youhaven't
shampooedforawhileandtherewillbesomeloosehairsreadytocomeout.Donot
pluckoutthehairwithtweezers!
1.Locateanareaonyourscalpthatcorrespondswithanareaonthediagram.
2.Graspatuftofhairclosetothescalpwithyourthumbandmiddlefinger.
3.Gentlysqueezethehairswhilesimultaneouslypullingthehairupwards.
a.Ideally,afewloosehairsshouldbereleasedfromthescalp.Inordertoperforma
morethoroughanalysis,2to3hairsshouldberemovedfromeachofthedesignated
areasandadheredtothediagram.
b.Thebulbmustbevisible.Itappearsasasmallwhiteballontheendofthehairthat
camefromthescalp.
4.Usingtape,affixyoursamplestothecorrespondingareasonthediagram.DONOT
placethetapeoverthebulb.
5.Sendtheformwithyoursamplesattachedtothefollowingaddress:
REGENIX
Cedars–SinaiMedicalOfficeTowers
8631WestThirdStreet
Suite420E
LosAngeles,CA90048