To Order Quantum Chelation Therapy from Terrapin Therapy

This is a good thing you’re doing for yourself. Sorry about the finger stick – but we do need 2 spots of your blood. Here’s that photo again as a reminder:

When you finish, wrap that Q-tip in a small piece of Saran Wrap. That will keep it safe.

We’ll also need the following form filled out. Copy and paste it into your word processing program – Word of whatever you use. With the form filled out, fold it in thirds, slip the Q-tip inside, and a check made to TERRAPIN THERAPY fOR $495 and mail it to:

                Terrapin Therapy
                Quantum Chelation Therapy
                919 Western Meadows Ct NW
                Albuquerque, NM 87114

If you prefer, you can pay with a credit card here:

We will notify you via email when your blood arrives, when we start therapy, after each therapy, and when the therapy series is complete.

INTAKE FORM

Name:                                                               Date:

Address:       

City:

State:

Zip Code:  

Phone: 

Email: 

Age:                Gender:

Place of birth:

Occupation:

Do you take vitamins daily?

Please list the supplements you are taking:

Other important information we should know:




Signature _______________________________________ Date______________