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Get your FREE manual and 20-minute trial session now:
Are you a new client to QT? Purchase any QT product and receive a free consultation with one of our practitioners within the next 60-days. You can pay $25 for a PDF version of either the QT client manual or the QT Parts Theory and Treatment Protocol and receive a free 20 minute session with a practitioner.

You can also receive a free download of either the QT Client Manual or the QT Parts Theory & Treatment Protocol right here (PDF format only).

This free offer does not include a free consultation. Check out our Products here.
Intake Forms

You have two options for filling out these forms:

 Submit Online

If you have Cookies, you may have difficulty submitting these forms online. If so, please print off the forms and complete them by hand as described in the option below.

If you wish to submit the forms online, please RIGHT-CLICK here and choose SAVE TARGET AS to download the form to your computer. Open the document and fill out the forms, by either clicking and typing to enter text or double-clicking to check the checkboxes. Be sure to save frequently so that you don’t lose your work. Finally, send an email to Cheryl at Cheryl@quantumtechniques.com, attaching your completed document to the email.

 PLEASE NOTE: The last two pages of the document (Payment Information and Non-Client Credit Card Authorization) MUST be printed, signed and faxed or mailed, so that your credit card data is secure.

 Print and Fill Out by Hand

If you wish to fill out the forms by hand, please click here. The document will open in a separate browser window. Simply print out the form from there. You may fax the completed forms to Cheryl Rodgers at (928) 771-1403, or mail them to her at:

Note: If you have questions about these forms, please contact Cheryl Rodgers at 888-767-8002 or 928-771-1215.

Quantum Techniques
PMB 494
3196 Willow Creek Road, Suite A103
Prescott, AZ 86301


Download this Adobe Acrobat PDF which includes the charts you will need:

Getting Started Quick Guide

It is critical for you to be familiar with these Time Saver Codes when you call for consultations.

If you have questions, or simply don't understand, that's ok, when you call for your consultation, we will help you learn to utilize this information.

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