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OFFICE SESSION WAIVER

Patient:  OFFICE WAIVER 2018

Please be advised that Dr. Katherine Crafton as a chiropractor does not "diagnose or treat" disease.  Use of any equipment in our office is generally purported to improve one's general health, and no other claims should be construed through its use.  Any knowledge of a specific medical health condition may have been shared, but, again, this is not to imply that the chiropractic doctor is treating any condition diagnosed by a medical doctor specifically licensed to treat these medical conditions.

We provide certain specific therapies only for "physical  medicine" licensed to be performed only for chiropractic purposes to improve function and to reduce discomfort.  Many of the other activities are considered separately distinct and are considered "activities" offered as "sessions" for the improvement of one's overall health.

We ask that if you are at all concerned about the influence of this session(s) that you first seek medical advice and, if necessary, approval whenever you believe it may pose any risk or interference.  We refer you to the manufacturer's information and/or website regarding features and benefits, such as FDA and Medical Device status, research, and testimonials, along with "disclaimers".  Also we have additional information on www.craftonclinic.com under "Health Patient Program" that we first ask you to read regarding this office's "terms and conditions".  Additionally, it is required that you complete and sign all intake patient paperwork to include personal data, informed consent, history, and financial agreement.

By signature, I assert that I have read the above statements, understand, and waive any responsibility regarding any use of an activity performed in this office.


Signature_____________________________________________Date__________

As the responsible parent and/or legal guardian for 

Name _________________________________________
 Age_______________


Signature_______________________________________________Date________