Services offered by Preventative Concept are for Quantum Biofeedback relaxation, stress and pain management. Our main concern in your health is to reduce stress and biofeedback is a health alternative that can be used to help reduce body stressors and stimulate the body to restore itself to a healthy balance.
Agreement:
I fully understand that the attending biofeedback practitioner's are not licensed medical doctors, rather they are stress reduction specialists.
I fully understand the difference between the practice of allopathic medicine, nutritional wellness consulting, and biofeedback therapy.
I fully understand that Preventative Concept advises that I should consult my own medical practitioner and medical professional for diagnosis, care, treatment or cure to any health condition. Biofeedback practitioners do not diagnose, treat, prescribe or claim to cure any disease.
I further understand that biofeedback is not a substitute for effective standard medical, chiropractic or psychotherapy treatment or veterinary treatment for my pet. Preventative Concept has advised me to continue ongoing medical treatment and therapies until otherwise advised by my psychotherapist, physician or medical practitioner. I
understand it is important for me to stay in close communication with my physician.
I further understand it is my responsibility to ask my medical doctor for permission to undergo biofeedback training if I wear a pacemaker or have any medical condition that may be exacerbated by relaxation.
I fully understand that the services provided by the biofeedback specialist/practitioners are not allopathic, but are nutritional, behavioral, or biofeedback in nature.
I fully understand that the attending biofeedback specialist perform their services within the parameters of natural health and wellness system using biofeedback and stress reduction.
I fully understand that the biofeedback specialists/practitioners do not offer allopathic drugs, surgery, or chemical stimulants or radiation therapy. I also understand that illness is not being diagnosed nor treated and that my wellness and stress are being measured.
I have solicited this referral for the attending biofeedback practitioner in good faith, exercising my free will and following the dictates of my own conscience which allow me to select what I understand is most beneficial to my health.
I fully understand that this referral for biofeedback relaxation, stress and pain management does not guarantee any healing outcome that may result from an interacting with a biofeedback practitioner. I understand that healing is not bound by particular time periods. I am of sound mind and able to make decisions about my own health.
I presently seek counsel, advice, opinions, biofeedback or points of view/or programs within the scope of the attending biofeedback practitioners' natural wellness and stress reduction practice.
I hereby release Preventative Concept from any and all liability with regards to the referral of a biofeedback practitioner outside of Preventative Concept.
This consent form contains the entire agreement between the parties, and supersedes any prior written or oral agreements between them concerning the subject matter of this Agreement.
I have read, understand and fully agree to the terms to engage in a biofeedback session, which has been explained to me by Preventative Concept. I authorize and consent to the performance of the foregoing services for the initial session and any session thereafter.
I have signed this Agreement and Consent Form freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me. My signature and/or *Digital Signature is proof that I have read this Agreement and Consent Form and agree to it's terms. I am 18 years of age or older and mentally competent to enter into this agreement.
*Electronic Submission Of Signature will be considered the same as your personal signature. I Agree
Signature:______________________________________
Date:_______________________________
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