Due to the nature of the services offered by The Chelation Clinic, medical clearance is required
before receiving any therapies.

getting started with ENERGY SHOTS

Injection Consent Form
Medical History Questionnaire

getting started with NUTRIENT INFUSIONS

IMMUNE ULTRA and IMMUNE SUPER ULTRA require a consultation for approval.
Lab work may also be required.

IV Consent Form
Medical History Questionnaire

getting started with CHELATION

CHELATION requires labwork and a consultation with our holistic medical team for
approval. Advanced diagnostic testing may be required.

IV Consent Form
Chelation Consent Form
Medical History Questionnaire
Required Lab Work
Required Medical Records

Not sure where to begin?

Schedule a FREE INTRODUCTORY CONSULTATION. Sit down with one of
our holistic medical team and get all your questions answered.

You can contact us by phone or e-mail to schedule your visit to The Chelation Clinic.

Call 706.507.0407
M - F 9 - 6* · Saturday 8 - 2
*Early morning and evening appointments available.

Or you can send us an email: elements@elementsnatmed.com

Cancellation Policy

We require 24 hours notice to cancel or reschedule appointments. Late cancellation or failure to arrive for an appointment
will result in a missed appointment fee equal to 50% of the cost of your scheduled service. For your convenience, we
will provide you with an appointment reminder by phone or email.