Patient Agreement - Good Health Geek

Holistic Healthcare Patient Agreement

This agreement must be signed by the patient, or parental guardian, before their scheduled appointment.

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Waiver & Release Agreement

I agree to the points stated below, in the Good Health Geek Holistic Health Care Release & Waiver Agreement. I release Stephanie Shipp, dba, Good Health Geek from any, and all liability.

Holistic Health Care Release & Waiver Agreement
Good Health Geek (goodhealthgeek.com)

In receiving health recommendations from Stephanie Shipp, dba Good Health Geek,
• I understand that no guarantees have been made to me as to the effect of services rendered.
• I understand and acknowledge that in no way are these services to be construed as the diagnosis, or treatment of disease, or mental health counseling, but rather as an aid to balancing my health, and to possibly improve my general physical, emotional, mental and spiritual wellbeing.
• I understand that holistic & homeopathic healing are not a substitute for medical treatment, medications, or mental health counseling. It is recommended that I work concurrently with a qualified doctor, or qualified medical professional for any condition I may be experiencing.
• I am aware that I may, or may not experience improved physical, emotional, mental and spiritual wellbeing from practicing the suggestions made by Stephanie Shipp.
• I understand that Stephanie Shipp does not diagnose illness, and does not prescribe pharmaceuticals, or medical treatments.
• I understand that all recommendations made by Stephanie Shipp, are “suggestions,” that should be discussed with my healthcare provider.
• If I choose to use herbs, supplements, or holistic medicines, I agree to have my healthcare provider assess my health during the use of such products.
• If I experience any discomfort or side effects during a session, or as a result of a recommendation, I will immediately communicate that to my holistic practitioner, so the treatment can be adjusted/or ended.
• I agree that it is my personal responsibility to communicate any changes in my health, or mental wellbeing, to my healthcare provider, as well as my holistic practitioner.
• I understand that I reserve the right to end a session, or remedy, at any time.
• If any medical issues arise from the use of a supplement, it is the legal responsibility of the manufacturer of that supplement. Stephanie Shipp can in no way be held legally, or medically liable.
• I release, waive, and indemnify Stephanie Shipp al, and Good Health Geek, including its employees, officers, owners, from any accidents, injuries, damages, or death for participating in any activities associated with my affiliation with (Good Health Geek).
• I am of legal U.S. age, which is 18 years old, or older.
• I am mentally of sound mind, and legally capable of signing this waiver.