Mandatory Client Form – Autonomic Coaching

Please Complete

Surname *

Name *

Email *

Disclaimer: No refunds will be given on goods ordered or subscriptions entered into

All information provided in this Report is provided for educational purposes only, including without limitation the ‘optimal ranges’ set forth in this Report. Neither this report, nor any of the information contained in this Report, is intended for or should be used for the purpose of, medical diagnosis, prevention, or treatment, including self-diagnosis, prevention, or treatment. This Report should not be used as a substitute for professional medical care, and should not be relied upon in diagnosing or treating a medical condition, ailment, or disease. The ‘optimal ranges’ set forth in this Report are general reference recommendations only and are not intended to be guidelines for any specific individual. The ‘optimal ranges’ set forth in this Report are for educational purposes only, and are not intended to be, nor should they be construed as, a claim or representation of medical diagnosis or treatment. Neither this Report, nor any information contained in this report, should be considered complete, nor exhaustive. This report does not contain information on all diseases, ailments, physical conditions or their treatment. This report is based on the lab data provided, which may or may not include all relevant and appropriate measures of your biochemistry. The absence of a warning for a given drug or supplement or any combination thereof in no way should be construed to indicate that the drug or supplement or any combination thereof is safe, effective, or appropriate for you. Statements made about a supplement, product or treatment have not been evaluated by the Food and Drug Administration (FDA) and any mentioned supplement, product or treatment is not intended to diagnose, treat, cure or prevent any disease. The information contained in this report has not been evaluated by the FDA. You are encouraged to confirm any information obtained from this Report with other sources and review all information regarding any medical condition or the treatment of such condition with your physician. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE, DELAY SEEKING MEDICAL ADVICE OR TREATMENT, OR STOP CURRENT MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ IN THIS REPORT. Consult your physician or a qualified healthcare practitioner regarding the applicability of any of the information or materials provided in this Report in regards to your symptoms or medical condition. Always consult your physician before beginning a new treatment, diet, exercise, fitness plan, or health plan or program, and before taking any drug, supplement, or any combination thereof; or if you have questions or concerns about your health, a medical condition, or any plan or course of treatment. If you think you have a medical emergency, call your local emergency services or your doctor immediately.

Please click below *

I understand and accept the content.

Signature

Clear

About Us:

Questions:

Misc.