Light, Sound and Vibration Waiver
I understand that the attending demonstrators are not allopathic doctors (MDs) and do not portray themselves to be but are providing Light, Sound and Vibration Therapy and wellness services. Procedures utilized include stress reduction therapy, wellness consultation and Light, Sound and Vibration Therapy. I fully understand that the attending demonstrators do not offer allopathic drugs, surgery, chemical stimulants, or any other conventional treatments. In addition, they do not diagnose, treat or otherwise prescribe for my disease, illness, or perform any act that would constitute the practice of medicine for which a license is required. I am fully aware and release Kinetic Harmonies to do a Light, Sound and Vibration Therapy session, wellness consultation, and other stress reduction protocols. By signing below, I acknowledge that I have read and understand all parts of this waiver and that I hereby affirm: I am NOT here for medical diagnostic or treatment procedures and I am here on this and subsequent visit solely on my behalf. By signing, I consent to Light, Sound and Vibration Therapy treatment and to allow Kinetic Harmonies to send me email notifications regarding the Kinetic Harmonies Rejuvenation Lounger Stress Reduction System and health and wellness related information.
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Full Name *
Email (We would love to keep in touch! Please provide your email.)
History of seizures? *
History of epilepsy? *
History of migraines/headaches? *
Do you have a Pacemaker? *
My interest in light therapy today is?
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