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PureWave Technologies

Informed Consent Agreement

 

 

  1. I do not have an implanted electronic device.

  2. I am not pregnant.

  3. I do not have epilepsy.

  4. I do not have severe heart rhythm disturbances.

  5. I have not recently received chemotherapy/radiation treatments.

I hereby request and consent to a service to be performed by Purewave Technologies, its staff and or representatives and give them permission and authority. I feel adequately informed to do so and I accept all liability for my health and wellness choices using their technologies.

I agree to be fully responsible for any damages, if I do not disclose any underlying physical condition or illness. I further understand Purewave Technologies representatives are NOT  licensed medical providers. They do not diagnose conditions nor do they prescribe or perform medical treatment, nor interfere with the treatment of a licensed medical professional.

 

I understand that the bio-energy sessions do not take the place of medical care. It is recommended that I see a licensed physician or licensed health care professional for any physical or psychological ailment I may have.  

I understand that PureWave Technologies does not make any promises of cures of any kind and results may vary.  I understand that results are not guaranteed. I also understand that PureWave reserves the right at their sole discretion to cancel appointments at any time. I also understand that I must give a 24 hour notice of cancellation or I will be charged the full amount of the service.

I hereby waive and release myself and my heirs, executors and administrators, from any and all claims of any nature whatsoever and do acknowledge that I will use the services provided at my own risk.

My signature below certifies that I have read, understood and agree to the terms outlined above. I confirm that I have given accurate answers and that I am legal age in this jurisdiction. 

Non Disclosure Agreement

Any and all technology discussed and shown are considered to be intellectual property of PureWave Technologies, and therefore will be treated as non disclosure information.

Please fill out form and sign. Once submitted you will be directed to the appointment section.