Complete all fields accurately and provide as much details on your medical history where indicated.
- By submitting this form, you are giving express consent to receive a Quantum Health Session.
- You understand and agree that a Quantum Health session does not replace current medical treatments or physician’s advice.
- Complete Payment using PayPal or Credit Card within 24-hours of your appointment. You may also mail a check in at least 1 week before your session.
- Schedule your appointment online using the Schedule Now Button.
- Please allow 24 – 48 hours for a response.