• FIRST VISIT EDUCATIONAL INFORMATION

    FIRST VISIT EDUCATIONAL INFORMATION

  • DoctorEarendil

  • Format: (000) 000-0000.
  • DATE OF BIRTH

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  • THEREBY ATTEST TO THE FOLLOWING STATEMENT:

    DISCLAIMER: Dr. Spindelilus is not licensed by the state of North Carolina in the healing arts.
  • BIOLOGICAL INDIVIDUALITY

  • It should not be misconstrued to mean, imply or indicate that the product or programs described here will cure anything, as no such claims are made. Only the body can heal itself. These nutritional suggestions are not offered as a cure, rather, as aids to the body in reestablishing normal functions. The human body is very complex. Although each person is similar in general structure and function, each is also uniquely different, responding differently to similar stimuli, therapies and conditions. What may help one person in a certain circumstance or condition, may not help another. This is also true with foods. A particular food that may be nourishing to a healthy person may cause an allergic reaction in another. Each condition may also be unique. Although thousands have had help from the natural methods described here, there have been and will be cases where destructive pathological changes are so severe, and the bodies own healing mechanisms so weakened, that the process of healing could be an extended process. Persevere, and your hard work will be amply rewarded. The information provided by Earendil M. Spindelilus D.N.M., N.D., M.H., C.R., PSc.D is for educational purposes only and should not be used to prescribe, diagnose, treat or cure any illnesses or diseases or as a substitute for professional health care. If you have a serious health problem, we strongly recommend that you consult a competent health care provider. Always consult with a qualified health care provider before deciding on any course of treatment, especially for any/all serious or life-threatening illnesses or diseases. The information provided has been suggested by herbalists, etc., as possibly being helpful and offers traditional and historical of any of our products and cannot be held responsible for any adverse reactions, side effects or misuse of any of our products. We assume no responsibility for those who prescribe our products for themselves. Our suggested use is as dietary supplements only. We strongly advise that you always use caution when taking any herb and/or medication other than those prescribed or suggested

  • 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., N.D., 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., N.D., M.H, C.R. PSc.D are not a PHYSICIAN nor a SURGEON. DISCLAIMER: He is not licensed by the state of North Carolina or any other state in the U.S. in the healing arts. In states that do not allow non-licensed Naturopathic doctors by that state to practice as Naturopathic Doctors, he practices as a degreed Doctor of Natural Medicine.

    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., N.D., 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., N.D., 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, N.D., 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.

  • Professional Wellness Alliance Membership Agreement

    Who We Are: The Professional Wellness Alliance is on a mission to assure that

    holistic providers have a defendable basis for offering their services and to bring individuals and families together with PWA licensed providers to learn ways to have the best in health.

    How it Works: Licensed providers, Individuals and families join in a private member community to share the services defined below. The PWA is structured asa private community that requires licensing for providers to assure provider ethics, competency, and quality services along with good community order. Services Provided: PWA licensed providers are authorized to assist members through health education, instruction and products. Services Not Provided: PWA licensed providers do not offer any state licensed health services, DO NOT take responsibility for the health of any person or for the diagnosis, treatment or resolution of any symptom or condition. How Do I Enroll as A Member: You may enroll as a PWA community member through the PWA website at https://www.pwai.us/become-a-member or througha PWA provider and you must agree to be accountable to the member rules shown below.

    Agree that Provider Members (PWA Licensees) provide only the services described above under "Services Provided" and that these are self-help and educational services not medical services. 1. Agree that all records of services you receive are available to you upon request as "private member educational records" and not medical records; 2. Agree that the Professional Wellness Alliance does it's best to assure the integrity and competence of Provider Members (Licensees) and while Licensees represent the PWA mission, that they are independent educators that do not work for the PWA. Therefore, you agree to hold the PWA and affiliates harmless in all matters related to your association with PWA, affiliates or Provider Members; 3. Agree to make your best efforts to resolve any and all complaint you may have with another member with them personally and in the event you are unable to resolve satisfactorily, agree to settle any dispute or complaint through binding arbitration through a mutually agreed arbitrator; 4. Agree that any and all content on the PWA website, newsletters, writings, affiliate links or otherwise are for educational purposes only and are not intended as medical advice.

    Term and Cancellation: Membership in the PWA shall begin when you agree to this Membership Agreement and shall terminate with written notice from you to the PWA or from the PMA to you. The PWA reserves the right to deny or terminate

  • membership of any member without cause. Termination shall not waive or relieve you of any obligations or agreements made while you were an enrolled member. By placing your signature below or agreeing to membership though the PWA on-line electronic system you accept membership and agree that this agreement is a "contract" binding you to follow the herein terms.

    Signature Enrolled Into Membership By: Dr. Earendil M. Spindelilus_ PWA Provider # PWA-4318546

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