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Client Consent Form
for Remote Quantum Health Checkup and Therapy

Your personal information is sufficient for remote health scanning and therapy. The client information is used only as a medium for the quantum connection between the device and the client and cannot be used for any other purpose.














I understand that my appointment time is reserved for me. More than one appointment missed or cancelled without 24 hours notice, will be subject to a cancellation fee. I understand and release the practitioner from any/all liability from problems arising as a result of information not given or withheld.

I understand that remote testing and treatment is a simple, gentle, energy technique that is used for stress reduction and relaxation. I understand that bioresonance practitioners do not diagnose conditions, nor do they prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of licensed medical professionals. I understand that distance healing does 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 distance healing can complement any medical or psychological care I may be receiving. I also understand that the body has the ability to heal itself and to do so, complete relaxation is often beneficial. I acknowledge that long term imbalances in the body sometimes require multiple sessions in order to facilitate the level of relaxation needed by the body to heal itself.

I understand that the information contained in this Consent Form will remain confidential and that it is gathered for treatment and administration purposes.

By my electronic signature, I acknowledge that I understand and agree to the terms contained in this Consent Form.






Important health information: This website describes a wellness-oriented service involving bioresonance/frequency-based methods. Such methods are not established substitutes for evidence-based medical assessment, and this service does not diagnose, treat, prevent, or rule out disease. For symptoms or medical concerns, consult a qualified healthcare professional.