MagnaWave Session Release

MagnaWave Session Release
Owners Name
Date

MonthDayYear
Date
Email
example@example.com
Phone Number
Address
City
State
Zip Code
Animals Name
Veterinarian Contact Info
Does your animal have a current injury and/or illness?Yes
If yes please describe
Is your animal under veterinary treatment?
If yes please explain
If your animal is taking any medications please list them and provide startend date if applicable
When was your animal last vaccinated
*PEMF creates more cell permeability and may increase absorption of medications, liniments, and topicals.

, agree to fully and forever release and discharge, and defend, indemnify, and hold harmless, the practitioner and/or practitioner's company, Pawsitively Unleashed!, and its owners, directors, officers, representatives, members, employees, or agents, and MagnaWave, and its owners, shareholders, directors, officers, representatives, employees, or agents, from any and all injuries (including death), losses, damages, claims (including negligence claims), demands, lawsuits, expenses, and any other liability of any kind, of or to me, my property or any other person, directly or indirectly arising out of or in connection with the PEMF services provided by practitioner and/or practitioner's company.
I
Signature

Clear
Date

MonthDayYear
Date
I (name printed) MagnaWave on (animal's name)
I name printed
MagnaWave on animals name
have permission to use on behalf of (animal's owner)
MAGNAWAVE
Advanced Technology, Trusted Results.
Should be Empty: