I hearby attest to the following:
1. That I am here on this and any subsequent visit, solely on my own behalf and not as an agent for any govenment agency on a mission of entrapment.
2. I Fully understand that Rema Azzawi is not a medical doctor and I am not here for medical diagnostic or treatment.
3. The services performed by Rema Azzawi are at all times restricted to the consultation on the subject of nutrition intended for builiding welness and do not involve the diagnosing, prognosticating, treating, or prescribing remedies for the treatment of a disease, or any act of which a medical licence or medical authorization is required.
4. This agreement is being signed voluntarily and not under duress of any kind.