NES Waiver Form
Wellness and/or Energy Therapy
- I fully understand that the attending practitioners are not allopathic doctors and do not portray themselves to be, but are wellness consultants and/or Biofeedback practitioners.
- I fully understand that the difference between the practice of allopathic medicine, holistic practitioners, and energetic and Biofeedback consultants.
- I fully understand that the services provided by the attending practitioner are not allopathic, but strictly energetic or Biofeedback in nature.
- I fully understand that the attending practitioner performs their services within the parameters of natural health care and wellness using Biofeedback and stress reduction or other energy therapies.
- I fully understand that the attending practitioner does not offer allopathic drugs, surgery, chemical stimulants, radiation therapy or any other conventional treatments. In addition, he/she does not diagnose, treat or otherwise prescribe for my disease, conditions or illness.
- I fully understand that my energy and stress parameters are being measured.
- I presently seek counsel, advice, opinions related to energetic balancing, stress management or Biofeedback within the scope of attending practitioner’s wellness and stress reduction practice. I am fully aware and release the energy practitioner to do Biofeedback and/or energy assessments.
- I fully understand that the services provided by the attending practitioner are in the emerging field of energetic medicine, and may not be understood by all allopathic practitioners.
- By signing below I acknowledge that I have read and understand all parts of this waiver and that I have the opportunity to ask any questions with regard to any services or therapies offered.