Consent to Participate and Acknowledgement of Services Open Form Consent to Participate and Acknowledgement of Services Name * First Name Last Name Email * Phone Country (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Checkbox * SECTION 1: PURPOSE AND NATURE OF SERVICES I, the undersigned, understand and acknowledge that Absurd Health is a faith-based wellness platform providing a range of services that are spiritual, naturopathic, educational, and holistic in nature. These may include but are not limited to: Scriptural and biblical counseling Inner healing, deliverance, and intercessory prayer Natural health coaching and lifestyle education Fasting and detoxification guidance Health retreats and immersive healing programs Recommendations regarding foods, supplements, herbs, and natural therapies I acknowledge that I have voluntarily elected to engage in these services of my own free will and without coercion or guarantee of outcome. Checkbox * SECTION 2: NON-MEDICAL STATUS & LIMITATION OF SCOPE I understand that Absurd Health and its representatives are not functioning as licensed medical providers unless specifically stated in writing and credentialed accordingly. I acknowledge that: No diagnosis, treatment, or cure is being provided for any disease, mental illness, or medical condition. Services rendered do not constitute the practice of medicine, clinical psychology, psychiatry, or pharmacy. Any reference to “healing” is spiritual in nature unless medically backed by a licensed provider under formal contract. I understand that fasting, dietary changes, and herbal or supplement use can carry risks, including but not limited to: Fluctuations in blood pressure or blood sugar Emotional or spiritual discomfort Temporary digestive or neurological symptoms Adverse reactions to herbs or supplements Increased elimination symptoms (“die-off” reactions) Aggravation of previously undiagnosed conditions I agree that no medical emergency care is offered through this platform. In the case of an urgent or life-threatening issue, I will contact emergency services or visit a licensed facility. Checkbox * SECTION 3: VOLUNTARY ASSUMPTION OF RISK I certify that: I am at least 18 years old and legally competent to provide informed consent I understand the nature and scope of services offered I am not under duress or pressure to engage in any particular practice or belief system I understand that outcomes are not guaranteed and that personal experiences may vary greatly. Any testimonials or healing claims made by others do not constitute a promise of results for me. I agree that I am solely responsible for monitoring my physical, emotional, and mental well-being during participation in any Absurd Health services. If I experience symptoms or distress, I agree to: Notify my licensed medical provider immediately Suspend participation if necessary Discontinue any supplement, practice, or activity I believe to be causing harm Checkbox * SECTION 4: LIABILITY WAIVER AND HOLD HARMLESS AGREEMENT To the fullest extent permitted by law, I hereby release, waive, discharge, and covenant not to sue Absurd Health, its directors, staff, practitioners, volunteers, contractors, or affiliates (collectively, “Released Parties”) for any and all liability, claims, demands, damages, or causes of action arising out of or related to: My participation in any program, service, or product My use of any recommendation, suggestion, or educational resource Any harm (physical, emotional, psychological, or spiritual) allegedly resulting from participation Any injury, illness, or reaction resulting from dietary, herbal, supplement, or detox protocols Disagreements or offenses arising from religious, spiritual, or theological content This release of liability applies regardless of whether the claim is based on negligence, breach of contract, or any other legal theory. Checkbox * SECTION 5: FAITH-BASED SERVICE ACKNOWLEDGEMENT I acknowledge that: Many services offered by Absurd Health are grounded in the Bible and the spiritual traditions of the Christian faith. I am voluntarily entering into spiritual or religious healing services and agree not to hold Absurd Health responsible for any personal or religious disagreements. I may choose not to participate in spiritual services, including prayer or deliverance, and my choice will be respected. I understand that spiritual discomfort, conviction, emotional release, or physical reactions may occur during healing prayer, fasting, or scriptural engagement. These are considered by Absurd Health to be part of the holistic healing process. Checkbox * SECTION 6: CONFIDENTIALITY & HIPAA ACKNOWLEDGEMENT I understand that: Any health information shared in a counseling or telehealth setting is protected under HIPAA, and Absurd Health has provided a Notice of Privacy Practices. Any spiritual or personal disclosures made outside a protected health context (e.g., during retreats, prayer sessions) may not be governed by HIPAA, but will still be treated with discretion and care. I understand that my data will never be sold, and I may request a copy, correction, or deletion of my records in accordance with federal law. Checkbox * SECTION 8: STATEMENT OF UNDERSTANDING AND CONSENT I HAVE READ THIS ENTIRE CONSENT FORM CAREFULLY. I UNDERSTAND AND AGREE TO ITS TERMS. I HAVE HAD THE OPPORTUNITY TO ASK QUESTIONS AND HAVE THEM ANSWERED TO MY SATISFACTION. By signing below, I affirm that: I fully consent to participate in services offered by Absurd Health. I understand the spiritual, non-medical nature of services. I release Absurd Health and all affiliated persons from liability. I take full personal responsibility for my health decisions. Thank you!