Wellness & Bio-Feedback Client Agreement

1. I fully understand that the attending technician is not an allopathic practitioner (MD) and
does not portray his/herself to be one but is a wellness consultant and Biofeedback technician.
2. I fully understand the difference between the practice of allopathic (conventional)
medicine, nutritional wellness consulting, and Biofeedback.
3. I fully understand that the services provided by the attending technician are not allopathic,
but are strictly behavioral, stress or Biofeedback in nature.
4. Any reference to patient within this Frequency balancing is solely due to the technical
terminology within the OBERON program and in no way implies that the client is a
medical patient.
5. I fully understand that the attending technician performs his/her services within the
parameters of a natural health care and wellness system using Biofeedback and stress
reduction.
6. I fully understand that the attending technician does not offer allopathic drugs, surgery,
chemical stimulants, radiation Frequency balancing, or any other conventional treatments.
In addition, he/she does not diagnose, treat, or otherwise prescribe for any disease,
condition, or illness, and that my wellness and stress parameters are being measured.
7. I have solicited the attending Bio-Feedback technician’s services in good faith, exercising
my free will and following the dictates of my own conscience which allows me to select what I understand is most beneficial to my health.
8. I also exercise my free will in asking this business and technician for their opinion on items
and situations which may expedite my good health; it is my choice should I accept to utilize or apply any of those ideas or suggestions at any time.
9. If I desire any services not provided by the attending Bio-Feedback technician, which is
my prerogative, I fully understand that I should seek them elsewhere. A referral for such
services can be arranged.
10. I presently seek counsel, advise, opinions, Biofeedback or points of view and/or programs within the scope of the attending technician’s wellness and stress reduction practice. I am fully aware and release the Bio-feedback technician to do Biofeedback stress interpretations and frequency balancing.
11. I fully understand that the services provided by the attending technician are not generally
accepted and/or recommended by allopathic doctors (MD’s) or other conventional health.
care professionals. I realize that insurance payment may be possible but is highly unlikely.
12. I understand that payment is expected at the time of service, unless otherwise arranged
prior to my scan.
13. I understand that I must call and cancel an appointment at least 6 hours prior to my scheduled appointment time. If I do not show up for a scheduled appointment I will be
charged full rate for that time.
14. By signing below, I acknowledge that I have read and understand all parts of this waiver
and that I have had the opportunity to ask any questions with regard to all such procedures.
15. The Food and Drug Administration have not evaluated these statements. This product is not intended to diagnose, treat, cure or prevent any disease.
16. I understand that is my responsibility to present myself when observing or participating
this session, when employed by the FDA or any other governmental agency.