I, First Name* Last Name* , agreeto indemnify, defend, protect, and hold harmless the medical providers employedby ADVANCED BIOCARE; and their respective officers, directors, employees,stockholders, assigns, successors, and affiliates (Indemnified Parties) from,against, and in respect of all liabilities, losses, claims, damages, judgments,settlement payments, deficiencies, penalties, fines, interest and costs,expenses suffered, sustained, incurred or paid by the indemnified parties, inconnection with, results from or arising out of, directly or indirectly, themedical providers employed ADVANCED BIOCARE; rendering medical care, services,advice, and/or treatment, my failure to disclose all relevant informationregarding my medical and physical condition, acts or omissions, the medicalproviders employed by ADVANCED BIOCARE: harm or injury resulting from medicalcare or pharmaceuticals provided directly or indirectly by the medicalproviders employed by ADVANCED BIOCARE. I am aware of the potential sideeffects associated with IV infusion and injectable therapies provided by ADVANCEDBIOCARE, accept all the risks involved with IV infusion and injectabletherapies, and will not seek indemnification or damages from the indemnifiedparties.