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Quantum Medical and Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form

Chiropractic Forms

Allergy Forms

Functional Medicine Forms


Forms for Dr. Carmen Jimenez L.Acup.

Download & Print New Patient Intake Form

Download & Print Informed Consent Form

Quantum Medical & Wellness Center

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Office Hours

Our Regular Schedule

Primary Location

Monday:

8:45 am-1:30 pm

2:30 pm-7:00 pm

Tuesday:

8:45 am-1:30 PM

2:30 pm-7:00 pm

Wednesday:

8:45 am-1:30 pm

2:30 pm-7:00 pm

Thursday:

2:00 pm-6:00 pm

Friday:

8:45 am-1:30 pm

2:30 pm-7:00 pm

Saturday:

Closed

Sunday:

Closed

  • "With Just 8 N.A.E.T. Treatments We Can See The Difference!!

    Austin is 8 years of age. He was diagnosed as attention deficit and hyperactive. A few weeks ago Austin began NAET. He had 8 basic treatments so far. He behavioral problems and temper tantrums have reduced greatly. He is more focused. Thank you Dr. Popkin!!"
    STEVEN S.*
  • "Breathing Normal Again

    My four year old son was in one of his extreme asthmatic attacks, even using his facial muscles to breathe-this after just having spent 2 hours on a hospital inhaler. A few moments after a treatment for water chemicals we listened to his lungs again – and they were normal. Thanks Dr. Popkin!"
    VINCE DEPORT
  • "Maureen is 16 years of age. She was born microcephalic. Later she was diagnosed as autistic,attention deficit and hyperactive. She also has a compulsive behavioral problem. A few weeks ago Maureen began NAET. She had 6 basic treatments so far. He behavioral problems and temper tantrums have reduced greatly. The tantrums have been reduced from 4 per day to 2 per week. Her speech is clearer and she is more focused. Thank you Dr. Popkin"
    STEPHEN J.