Thank you for choosing to provide additional information about your health history and lifestyle - this will make the first session with your practitioner flow more smoothly and be less costly!
To review the more than 90 questions that are to follow, please preview or print this entire form at The QT History Form
For TECHNICAL SUPPORT or to submit this form by telephone, contact Cheyene Stone:
Office: U.S. 855-QT Heals (784-3257) | World 1-786-567-8663 | Email: firstname.lastname@example.org
If you have questions on anything related to this process call the QT Office Manager, Cheryl DeMauro, at 928-771-1215 or 888-767-8002.