TEST ORDER AUTHORIZATION FORM FOR REGISTERED PRACTITIONERS
Fresh Start’s Authorization Form is for Certified Daphne Points Only
If you are not a certified Daphne Point™ (registered Practitioner), please register with Fresh Start™ here.
AUTHORIZATION FORM STEPS
After you have provided your Client/Patient with an In-Office Fresh Start™ Test Kit, please follow the steps below.
1. Complete and sign the online Authorization Form
2. You will receive an email from Adobe Sign
3. Click on the link in the email to confirm your signature/email address
4. A copy of your signed Authorization Form will automatically be emailed to you and Fresh Start™
NOTE: When Fresh Start™ receives the client/patient’s completed Requisition Form 62 and hair sample, the practitioner will be invoiced for the order.