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Consent and Release of Liability
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Check if Yes
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Cardiac Pacemakers or other electrically powered implant
Pregnant
Cardiac Fibrillation
Recently Consumed Drug or Alcohol
Sensitivity to Electrical Current
Severe Mental Disorder
Organ Transplants
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Open Wounds
Phlebitis or Thrombophlebitis
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Menstruating
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History of Fainting
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High or Low Blood Sugar
High or Low Blood Pressure
Botox Treatments
Have Not Consumed Water in the Past Two Hours
Other Complaints
*
Medications
*
Scars? Locations
*
WAIVER OF LIABILITY
I understand the Avazzia device imparts electrical
frequencies into the body. I have truthfully answered the above list of contra-indications/cautions for this therapy. Avazzia does not prescribe medical treatments or diagnose. It is recommended that I see a physician for any physical ailment that I may have. I have stated all my known medical limitations. In consideration of the treatment offered to my I agree that I will not institute any suit or claim against Avaz-zia, their representatives their employees, or practitioners for any damage, loss or injury to either person or property. I am in good health and have no physical limitations which would affect my safe use of the devices. I am at least 18 years of age and otherwise legally competent to sign this agreement. This release shall be effective and binding upon me and my assigns.
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Home
Buy Avazzia
Buy QRS
Buy Gut Check Test
About
>
Our Story
FA Testimonal's
Research
Patients
Patient Overview
Find a Practitioner
Testimonials
Prescription Information
Professionals
Avazzia Microcurrent
>
Overview Of NeuroStimulation
BEST Technology for your practice
Why Avazzia Works
HCP who use Avazzia
Professional Resources
>
Pain Study
Products
Avazzia Microcurrent
>
For Professionals
Home Pain Relief Rx
OTC Pain Relief
QRS PEMF
>
QRS 101 Home System
>
QRS Frequency Programs
QRS Healthy Cells
QRS 101 Homesystem Technical Data
QRS Key-Lock Principle
The Quantenmedicine
QRS 101 Video's
QRS Metabolism of The Cell:The Ion Transport
Gut Check Test
>
FA Test Series
>
FA-01 Gut Check Test For Patient
FA-01 Gut Check Test Series for Patient
FA-01 Gut Check Test for Practitioners
Accessories
Support
Contact
Pharmacy Lead Page
Rep Lead Page
Rent First, Buy Later
>
Avazzia Rental Units
QRS Rental Units
Service Request
Forms
>
E-Waiver
Frequently Asked Questions
TroubleShooting
Safety Precautions
Policy, Warranty, And Returns
Training
Advanced Learning
Shop
