HTMA Order Form

FOR PRACTITIONERS IN RESTRICTED STATES

Please complete this form to request an HTMA (Hair Tissue Mineral Analysis) order through Emmalee's Trace Elements practitioner account.

Tests are ordered at lab cost only — no markup — plus a $1 fee to cover postage for shipping the kit.

Please note: Ordering through this form does not include interpretation, consulting, or protocol support. If you'd like guidance on using the results, you’ll need to interpret them independently or book a separate consult.

Once you submit the form, I’ll confirm your order and send you the total and payment instructions if payment has not already been made via PayPal. Turnaround time for shipping kits is usually within 2 business days.

Kits will not be shipped until payment is received.

PayPal email is hello@integrativemetabolicwellness.com - please add description HMTA Practitioner Order for Client [client’s initial’s] (example: HTMA Practitioner Order for Client ET)

Practitioner Name

First Name

Last Name

Practitioner Email

Results will be delivered to this email address.

Client Name

(for record keeping only)

First Name

Last Name

Are you ordering for multiple clients at the same address (e.g. family members)?

If ordering for multiple clients at the same address, please list the first names of each client you’re ordering for.

You only need to complete one form per address. Please indicate the test profile (Profile 1 or 2) for each person if not all the same.

Which profile would you like to order?

Shipping Address for Kit

Message

Has payment already been sent via PayPal?

Please note that kits will not ship until payment is received.