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To establish and clarify my purpose in coming to you for a consultation, I want to clearly state that my interest is learning a good path to follow and a good nutritional program. I want to change my present habits and establish habits and a new way of living to build good health. I understand it is my personal decision to follow your nutritional program or not to follow it.

I thoroughly understand that this program does not replace any additional professional counseling with any other doctor I may wish to consult; that your analysis and nutritional consultation are an adjunctive analysis which can be coordinated with any advice, treatments, or prescriptions whatsoever with my regular physician; that this program is not intended to be in any conflict whatsoever with any other  recommendations or treatments by other doctors or practitioners who are licensed by State and Federal laws; and also, that the decision to follow or reject this program is left to my own discretion. 

In addition, I fully and completely understand that you do not diagnose, treat nor do you make any recommendations for the treatment of any disease (including cancer, AIDS, etc.) in any form or in any manner whatsoever and wish to assure you that I am in no way asking for such treatment at this time or will I be asking for such treatment at any other time.

Again, I wish to state that I clearly understand that this analysis and consultation and any follow-up analysis and consultation are not meant to take the place of any other form of analysis, counseling, diagnosing or treatment by regular physicians or any other doctor or health practitioner.