Breakthrough Rapid JOINT Pain Relief Program in Amarillo, TX

📍1901 Medi-Park Dr, Suite 2036

Amarillo, TX 79106

📞 (806) 591-3359

Breakthrough Rapid JOINT Pain Relief Program in

Amarillo, TX

Check YOUR Eligibility

Who are you filling this out for? *

Myself

Husband

Wife

Daughter

Son

What joint pain symptoms are you experiencing? *

Constant Joint Pain

Popping or Crackling when walking

Swelling and stiffness

Difficulty sleeping from discomfort

Unable to bear weight on the joint

Inability to fully straighten the joint

All of the above

Some of the above

On a scale from 1-5, 5 being “excruciating”, how bad is the pain in your joint(s)? *

How long have these symptoms been bothering you? *

Less than 1 year

1 - 3 years

4 - 6 years

6+ years

Have you been told you're a candidate for joint replacement surgery? *

Yes

Have you been diagnosed with any of the following joint conditions? *

Joint degeneration

Arthritis

Meniscus tears

Osteochondritis dissecans

Sprain or Strain older than 6 weeks

All of the above

Some of the above

Financing options are available based on your credit. Which option best describes your credit history? *

Below 650

650-700

700-750

750+

Is 1901 Medi-Park Dr, Suite 2036Amarillo, TX 79106 commutable for you? *

Yes

What is your Zip code? (this helps us know that we are reaching people in our area) *

Full Name *

What is your best email address? *

What is your best phone number? *

I agree to the terms & conditions provided by QC Kinetix Amarillo, and by providing my phone number, I agree to receive text messages from QC Kinetix Amarillo.