I understand that Mercier Therapy is a soft tissue visceral manipulation
therapy technique used to help and restore the health and general well being
of the female pelvis.
I understand the goal of Mercier Therapy pelvic treatment is to decrease
adhesions in and around organs, ligaments, muscles, joints, and support
structures of the pelvis, abdomen, hips and low back.
I understand that if I experience any pain or discomfort during a session, I
will immediately inform the practitioner so that the pressure and/or
application may be adjusted to my level of comfort.
I understand that Mercier Therapy should not be construed as a substitute for
a medical examination, diagnosis or prescription. I should see a Gynecologist,
Reproductive Endocrinologist or other qualified medical specialist for any
physical ailment or suspect condition I might have.
I understand that Mercier Therapy is not intended to take the place of
medical/surgical intervention and my practitioner, Jennifer Mercier, ND, PhD
shall not bear any responsibility for any ill effects should I choose to NOT
adhere to my primary doctor’s advice.
I understand that the practitioner is not qualified to diagnose, prescribe or
treat any emotional or mental distress and nothing said in the course of the
session (s) given should be construed as such.
Because Mercier Therapy is contraindicated (should not be done) under
certain medical conditions (IUD, Essure, Endometriosis during menses, any
present cancer cells) I affirm that I have stated all my known medical
conditions and answered all questions honestly. I agree to keep the
practitioner updated as to any changes in my medical profile and understand
that there will be no liability on the practitioner, Jennifer Mercier, ND, PhD
should I forget.
Supplements recommended or suggested to me are taken/ingested by my
choice/decision. I will not hold the practitioner, Jennifer Mercier, ND, PhD
responsible nor liable should I have an adverse or allergic reaction.
I understand that most of the supplements should be discontinued at the first
determination of pregnancy.
I understand the remainder of treatment sessions will resume post partum
should I conceive during the program.
I will honor all office policies including but not limited to payment,
cancellation notice, tardiness, and conduct. I understand refunds are not given
for any reason.
I understand compliance is necessary for successful treatment progress and
results. I understand there is no guarantee of pelvic cure or pregnancy.I
have read, fully understand, and agree to the above terms and conditions