Energetic Medicine

Informed Consent of clients that want to be treated with the Health Navigator, Health Integrator or Bio-LaesEr

(Here collectively called HN-Devices)

I have been informed that my Therapist

(your business information here)

Is using HN-Devices as (please circle only one)

A – Medical device
B – Wellness device that re-educates my mind and/or body
C – Spiritual healing device

I understand that in case of B or C any physical or energetic changes that occur during or after the therapy were neither intended nor could they be expected. I agree with the consensus of contemporary science that with the minute energies applied by HN-Products such changes can only be coincidental or the result of hyper-sensibility.

To exclude the possibility for the latter I confirm that I:

1. DO NOT SUFFER FROM ELECTROMAGNETIC SENSITIVITY
2. do not have a pacemaker
3. do not have any metal implants
4. am not pregnant
5. do not have an inflammation of the skin,
6. do not have an eczema or a wound in the area of the electrodes.
7. have not had or have a seizure disorder
8. do not suffer from long-lasting pains with unclear reason
9. do not have or any other indications of a particular sensitivity to electromagnetic energy

And in case of therapy that involves a light applicator I confirm that I do not have:

1. allergy to sunlight or a lack of pigment,
2. been taking drugs which increase the responsiveness of light
3. any inflammations
4. hyper function of thyroid,
5. any urgent infectious disease
6. or any other symptoms of light-hypersensitivity

Regarding all the above I was not confident to confirm myself, I have first consulted a qualified professional health practitioner for advice.

Date                                 Name                                                                Signature

Therapist informed consent form

to Health Navigator, Health Integrator or Bio-LaesEr
(collectively referred to as HN-Products)

I _____________________________ understand that HN-products are powerful and potentially life changing systems, therefore every one of my clients needs to sign the “HN-Disclaimer for clients” .

I understand that only the Health Navigator is approved as a medical device in the European Union and that its use as such is limited to Wound-healing, Depression and Pain Therapy. Furthermore its use as such requires that I am qualified to use medical devices.

Optionally the Health Navigator as well as all other HN-products come with a Wellness CE that certifies their technical safety which however does not allow me to make any medical claims.

Therefore I will promote my services exclusively either as “Wellness body and mind education” or as “Spiritual Healing work”. In both cases I will make it known to my clients, in advance, that any possible physical or energetic health changes are purely coincidental and are neither expected nor intended.

I understand that particularly the Bio-LaesEr is a potentially very powerful healing tool, despite the very minute energies applied. The Bio-LaesEr is the first device that uses client-Eigen-Frequencies for therapy and it is therefore necessary to make sure that the client has no implants and acknowledges that he needs to confirm that he has no hypersensitivities to light, magnetism or electricity and if in doubt consults another health care professional before undertaking any treatment.

In some cases the body might display little points of irritation, at the points where the electrodes were applied – these might resemble little burns – which however never have been experienced as such and are a form of initial healing aggravation. These signs may occur at voltages as little as 1 Volt and therefore cannot be the result of any physical burn nor has ever any sensation of burn been reported – but it is necessary to state the appearance of such symptoms before starting the treatment.

I understand that for some clients the significant health-changes that are possible with HN-Products, although positive, will be experiences as a threat to stagnant life pattern that have developed over many years and thus have established a sense of security. Healing can thus be perceived wrongly as a deprivation of that security and as a too unexpected impulse for change that trigger new and possibly violent symptoms of resistance – frequently will be blamed on the therapist.

Therefore I understand and accept the above as well as the need for proper education of my clients and that the disclaimer that is provided by Health Navigator LLC is signed before any treatment is commenced.

____________________
Signature and Date/ Place