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 joint function and to reduce discomfort. Many of the other activities are considered "activities" offered as "sessions" for the improvement of one's overall general 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. 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 with the understanding that the doctor is making no specific claims or guarantees. Dr. Katherine is not treating any diseased state diagnosed by a medical doctor.
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As the responsible parent and/or legal guardian for
Name _________________________________________ Age_______________
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