by a health care provider. For children under the age of 12, pregnant or nursing, please use caution unless under the advice or supervision of your health care provider. Always read and follow all label directions. All herbs should be kept out of the reach of children. Any claims and/or statements on the use(s) of any herb have not been evaluated or approved by the FDA. Earendil M. Spindelilus D.N.M., M.H. C.R. PSc.d has obtained his degree as a Master Herbalist from the School of Natural Healing, The College of Herbal Medicine. He also received his Doctorate in Natural Medicine from New Eden. He has been practicing since 1999. He is also a certified Nutritionist and Certified Reflexologist. He is not licensed in this state nor is a license required for this type of practice. I fully understand that the partners of, and Earendil M. Spindelilus D.N.M., M.H, C.R. PSc.D are not a PHYSICIAN nor a SURGEON. DISCLAIMER: He is not licensed by the state of California in the healing arts.
I also fully understand that I am hereby advised to continue my current medical treatment and/or seek the assistance, advice and professional help of a licensed Medical Doctor and/or Hospital for any diagnosis and/or treatment of disease, illness or health problem that I have. I am also advised to continue any current medical program I am currently on including but not limited to Surgery, Chemotherapy, Radiation, Any Drug Therapy and any other treatment for disease. I also fully release and relinquish my right and/or the right of anyone on my behalf to prosecute and sue Earendil M. Spindelilus D.N.M., M.H, C.R. PSc.d and/or anyone associated with then for any and all reasons but especially in regards to their assistance, health consultations, emotional guidance, nutritional and herbal products, custom formulations and herbs. I hereby indemnify and hold harmless Earendil M. Spindelilus D.N.M., M.H, C.R. PSc.d and/or anyone associated with them listed or not listed, including the companies that Earendil M. Spindelilus D.N.M, M.H, C.R. PSc.D does business with, from any and all reasons inclusive but not limited to; my voluntary usage of any herbs and herbal formulas or health and nutritional products, and for any possible damage and/or losses resulting from any act regarding my health program and consultation.
***WE REQUIRE 24 HOUR NOTICE FOR APPOINTMENT SCHEDULE CHANGES.
IFAPPOINTMENT SCHEDULE IS MISSED OR CHANGED WITH LESS THAN 24 HOUR NOTICE WE WILL CHARGE FOR THE FULL CONSULTATION FEE***
By signing this form you agree to all.
I understand that this release is valid for this visit and subsequent visits as well.