Therapeutic Love

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Therapeutic Love Wellness

Waiver, Informed Consent & Release of Liability

Light Therapy · Frequency Light Therapy · BEMER® · PEMF · Hydrogen Therapy · Brown's Gas Therapy · Vibroacoustic Therapy · Wellness Education & Coaching

Excludes Hyperbaric Oxygen Chamber — separate waiver required

Your information

I understand that the services and information provided by Therapeutic Love Wellness are not intended to diagnose, cure, treat, mitigate, or prevent any disease or medical condition. Services are provided for general wellness, relaxation, education, stress reduction, nervous system support, and lifestyle optimization. These services are not a substitute for medical diagnosis, treatment, or care from a licensed healthcare professional. I understand that I am responsible for my own health and well-being, and I should consult with my licensed healthcare provider regarding any medical conditions or concerns.

The wellness services I may receive include, but are not limited to:

Light Therapy & Frequency-Based Light Therapy

Use of specific wavelengths and frequency-modulated light designed to support relaxation, circulation, cellular function, recovery, and overall wellness.

BEMER® (B.E.M.E.R.)

Bio-Electro-Magnetic-Energy-Regulation

A pulsed electromagnetic field technology intended to support healthy microcirculation and general wellness.

Hydrogen & Brown's Gas Wellness Sessions

Hydrogen and Brown's Gas sessions are intended to support general wellness. Brown's Gas contains hydrogen and oxygen. Oxygen is utilized by the body while carbon dioxide (CO₂) and other waste gases are naturally expelled through respiration.

Vibroacoustic & Frequency-Based Therapies

Sound, vibration, and frequency technologies intended to promote relaxation, nervous system regulation, and overall well-being.

Education & Coaching

Educational and coaching services are intended to provide information regarding lifestyle, wellness, stress management, and self-care practices. These services are educational only and are not medical advice.

Benefits May Include:

  • Relaxation and stress reduction
  • Improved circulation
  • Increased energy and vitality
  • Support for cellular health
  • General sense of well-being

Possible Temporary Responses May Include:

Warmth or tingling sensations · Temporary fatigue · Increased relaxation · Increased energy · Emotional release · Temporary dizziness or lightheadedness · Temporary changes in symptoms

For diagnosis and treatment of any disease, consult a licensed physician.

Are you / do you currently have any of the following? (Please mark Yes or No)

Pregnant / Breastfeeding
Low Blood Pressure
High Blood Pressure
Epilepsy / Seizures
Active Cancer
History of Cancer
Autoimmune Condition
Heart Condition
Stroke / TIA History
Diabetes
Thyroid Disorder
Respiratory Condition
Active Bleeding
Bleeding Disorder
Infectious Disease
Sensitivity to Light
Photosensitivity
Sensitivity to EMF
Taking Prescription Medications
Taking Blood Thinners
Taking Nitrates
Undergoing Chemotherapy
Currently Under Medical Care
History of Fainting or Dizziness
Pacemaker or Implanted Electronic Device
Metal Implants or Joint Replacements
Organ Transplant Recipient
Deep Vein Thrombosis (DVT)
Pulmonary Embolism (PE)
Current Blood Clot or Clotting Disorder

If you answered YES to any item above, Therapeutic Love Wellness may require physician approval prior to participation in certain modalities.

Please check all modalities you are interested in learning about or receiving services for: *

Release of Liability (California)

I voluntarily choose to participate in services offered by Therapeutic Love Wellness. I understand that participation in wellness services involves inherent risks that cannot be completely eliminated. I knowingly and voluntarily assume all risks associated with participation.

To the fullest extent permitted by California law, I release, waive, discharge, and hold harmless Therapeutic Love Wellness, its owners, operators, practitioners, employees, contractors, volunteers, affiliates, and representatives from any and all liability, claims, demands, damages, losses, costs, expenses, actions, or causes of action arising from or related to participation in any service, consultation, educational program, wellness modality, recommendation, or coaching session.

I acknowledge that these services are non-medical wellness services and that no guarantees regarding outcomes have been made.

I understand that I may discontinue participation at any time.

By signing below, I acknowledge that I have read, understand, and agree to the above. I have had the opportunity to ask questions, and all of my questions have been answered to my satisfaction.