Rē Group Program Waiver

Rē Precision Health
Please read through this waiver to understand and acknowledge the therapies and associated risks that form part of this program.

Full Terms of Service here.
By checking here, I acknowledge that I bear sole responsibility for my own personal health decisions. Rē Precision Health and this program are not a replacement for any medical treatment or advice and will not be held responsible for any decisions I make regarding my own health.
By signing, I agree to the above waiver and the Terms of Service
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.
Full Name

First NameLast Name
Retreat Start Date

MonthDayYear
Date
Retreat End Date

MonthDayYear
Date
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Date
Date of Birth
Emergency Contact Name

First NameLast Name
Emergency Contact Email
example@example.com
Emergency Contact Phone

Area CodePhone Number
Should be Empty:

Rē Precision Health