The above information is true and accurate to the best of my knowledge. I understand that I am here to learn about nutrition and better health practices, that I will be offered information about food, supplements, and herbs as a guide to general good health. I fully understand that those who counsel me are not medical doctors and I am not here for medical diagnostic purposes or treatment procedures. The services performed here are at all times restricted to consultation on nutritional and Chiropractic matters that are intended for the maintenance of the best possible state of natural health, and do not involve the diagnosing, treatment, and/or prescribing of remedies for disease. In affirming this understanding, I take complete responsibility and liability in regards to my own health and choice to receive these holistic health services and consultations As a result, I accept any and all reactions to the choices that I make during and after said consultation. And in accordance with this understanding, I release any and all liability from Ralls Family Chiropratic, LLC / Samuel I Ralls DC, in the event of any such reactions or damages during and following the consultation process. I also affirm that I am not on this visit, or any subsequent visit, an agent for federal, state, or local agencies or on a mission of entrapment and/or investigation of this establishment,