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Wellness I.Q. Test with Suggestions
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Solex AO Scan Mobile Consultation Consent Agreement and Liability Waiver
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Participant
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Independent Quantum Living Advocate
_____1. Unless legally licensed as a medical practitioner, I fully understand that the Solex Independent Quantum Living
Advocate who is assisting me with this analysis using AO Scan Mobile, is simply facilitating the technology.
_____2. Unless legally licensed as a medical practitioner, I fully understand that the Solex Independent Quantum Living
Advocate who is assisting me is prohibited from diagnosing or treating any disease, condition, or illness by prescribing
medication, offering medical advice, conducting surgery, or providing any other medical services.
_____3. I fully understand that the AO Scan Mobile analysis is strictly educational in nature and does not diagnose, treat,
cure, or prevent any disease.
_____4. I fully understand and acknowledge that the AO Scan Mobile uses subtle energy, frequencies, vibration, and
resonance to interact with the body’s energy field and measure my body’s response. When it encounters imbalance, it
reports those imbalances to me and helps optimize my wellbeing by identifying frequencies that may restore balance.
_____5. I fully understand that the analysis provided by the AO Scan Mobile is leading-edge technology and is not yet
generally accepted by conventional health care professionals. An AO Scan Mobil analysis is not covered by medical
insurance.
_____6. I fully understand that any payment for an analysis is expected at time of service, unless otherwise arranged prior
to my session.
_____7. I acknowledge that no national regulatory body has evaluated any statements made regarding the AO Scan
Technology. AO Scan Technology is not intended to diagnose, treat, cure, or prevent any disease.
_____8. I affirm that I am acting of my own free will and according to the dictates of my own conscience to experience an
AO Scan Mobile Analysis.
_____9. I affirm that I do not represent, nor am I an agent for any state or federal regulatory agency.
_____10. I affirm that I am requesting this analysis for myself and not for legal recourse.
_____11. With the acceptance of this consent agreement and liability waiver, I hereby waive and release myself and my
heirs, executors, and administrators, from any and all claims of any nature whatsoever and do hereby acknowledge that I will
use the services provided at my own risk. I confirm that I have given accurate legal direction and that I am of legal age
or guardian.
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