Release form for frequency treatment

[Daniel Bergman]

I am starting to have people who would want me to try treat a condition of one kind or another, usually one that has not been resolved by conventional medicine.

I am looking to protect myself from any future problems related to treating people with frequencies as an experimental treatment.

Does anyone have a liability release form of some kind that covers this area?

Thank you.

Dan Bergman

[Marshall Stanton]

Dan'
Dr Johnson wrote some for himself and a few other doctors. There are copies to see.
Hopefully theirs is up to the technical application of the therapy.
It looked like it would cover most of what we do.
Than again?

Marshall

[Daniel Bergman]

Part of the problem is I am not a health care provider in any respect, so I have additional considerations that an MD would not.

I have been advised by a member of the forum that the only safe way to do this is to have people treat themselves. They would be using my equipment, and running it themselves. I can tell them what to do, but I should not touch or run the equipment.

Then, if the situation ever comes up where I am under some kind of scrutiny from authorities, I can honestly say "I never have treated anyone outside of my family". We are allowed to treat family members under current law. I only allowed unrelated people to use my equipment, but did not treat anyone.

I do think this would be the safest course to take, although somewhat awkward in practice.

Dan

[Alan Faulkner]

Does anyone have a release form that might be useful?

I've seen some online.

[Russell Shipp]

Everything I do , I do for gratuity.

I'll treat anyone willing to be treated.. although I never use the word treatment. Not till me and the client have been through a few sessions and gotten to know one another.


I don't use a release but if I did I should think that a good release form would look contractual.



I_______________________, Here by understand that I am being allowed to use ________________s' device under their supervision and that now medical claims are promised or implied. Use of their device is to be considered for entertainment purposes only.




Seems simple enough.... and should someone get cured and then get pissed off about being cured and call the authorities on you for Illegal healing... You can use my plan..... Should that happen to me I am gonna praise god and pass all the blame on him for providing the miracle.

[Richard Di Nucci]

Russell:

I am a newcomer to the Rife Forum, and I'm not a lawyer by trade. I commend you for starting this "release process", and hope that we can refine the wording soon, so that others on this Forum can use it whenever they feel the need to do so.

Since I know a fair amount about contract law, I've reviewed your draft "Release Form", as shown above (written in August 2012!), and I suggest a number of additions as well as clarifications.

Accordingly, here's my suggested re-write:
I, _________________________ fully acknowledge the implications of the following four (4) statements listed below; further, I fully understand, acknowledge, and accept the potential consequences of my actions either expressed or implied by the four statements below.

1. I have received a “Rife-type” of device, Model # _________________ (hereinafter referred to as “device”). I received this device from ________________________ on the date shown below.

2. I have been trained in the specific procedures that are to be used in connection with the safe operation of this entertainment device, and in specific safety precautions that are to be followed, before, during and after use of this device.

3. While in my possession, this device is to be used on an experimental basis by me only, and for the expressed experimental purpose of treating my own ailment(s), which I characterize as follows: ________________________________, __________________________, and _________________________________. (To All: Does this second portion of Statement # 3 sound OK to leave in, or should we delete any reference in this Release Form to "treatment of ailments"?)

4. Use of this device is for entertainment purposes only; however, I realize that in the process of using this device, I may experience some slight changes.
(Does that take care of any potential problem in Statement # 4?)



Signed: _________________________ and _______________________________
Temporary User of Device Owner of Device

Date: Date:

[Russell Shipp]

careful about consenting to admitting any kind of medical benefit. Otherwise it is a beautiful piece of leagliease.

But yeah, when people say Rife cures, they tend to end up doing time. Sometimes for right sometimes for wrong. .... IDK.. I'm about to reach for a larger market using sub par machines that are work horse ready. These mules may not be flashy but they are good mircals to be shared with as many as possible that will be willing to utilize them.

Thats my two cents.

I like your release much more.;

Save more that one part of part 4. ....... Lest anyone among us have to serve time for attempting to save a person.

[Richard Di Nucci]

Thanks Russell.

I'll try my best to incorporate your thoughts/ ideas in a revised version, which I hope to post back here on this link shortly.

R

EDIT: I've modified the draft Release Form" in the prior post; also shown in red are remaining questions for anyone who sees a potential issue or problem with the wording.

[Moria Merriweather]

I've signed so many releases like this, you'd think I would know what it should say!

Regarding the legal issues, I think there can be issues in any case, but I would note that it is much more complex if charge money for the use of the machine. Most of the issues I've heard of are when someone is selling something and makes claims for it. If you are. Not selling something (device or substance) and you want to give advice on treatment, you could still be liable in some cases, but it is more limited. In health books there are still disclaimers, but what you can say in a book is much broader than what you can say if you are treating someone for money.

[Russell Shipp]

Good reasons to never charge money for it! What is the price of life?

[Richard Di Nucci]

Thanks, Moria.

Although I implied that there was no compensation, we need to be explicit. I'll amend what I've written above, to clarify that the "caregiver" is receiving no compensation.

R
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[Richard Di Nucci]

Release Form for Rife Frequency Treatment – Revision 3

( note: recent additions/changes are shown in red)

I, _________________________ fully acknowledge the implications of the following six (6) paragraphs listed below; further, I fully understand, acknowledge, and accept the potential consequences either expressed or implied by these statements below.

1. I have received a “Rife" device, Model # ___________________ (hereinafter referred to as “device”) on temporary loan, for a maximum period of two weeks, from ________________________ on the date shown below. Further, while in my possession, I am responsible for the safe-keeping of this device.

2. I have been trained in the specific procedures that are to be used in connection with the safe operation of this device, and I have been trained in specific safety precautions that are to be followed, before, during and after the use of this device.

3. While in my possession, this device is to be used on an experimental basis by me only, and for the expressed purpose of treating my own ailment(s), which I characterize as follows: ________________________________, __________________________, and _________________________________. (To All: Does this second portion of Paragraph # 3 sound OK to leave in, or should we delete any reference in this Release Form to "treatment of ailments"?)

4. Use of this device is for experimental purposes only.

5. Though the maximum duration in my possession is specified in Paragraph # 1 as two (2) weeks, the device owner may request the return of this device after three (3) days, if necessary.

6. The device owner is receiving no compensation of any kind for allowing me to borrow this device.

Signed below by the Owner and the Temporary User of this Device:


_______________________________________
Temporary User of Device Date

_______________________________________
Owner of This Device Date


Question to Forum Members: Does anyone have additional suggestions/ changes? Or is there another “template” other than this draft above that will suffice?
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[Guichard Pierre]

The only solution to the people on the track and let RIFE
do some work alone. leave them assimilate technical RIFE first.
if they want to heal they work for themselves in a first time .

[Moria Merriweather]

Richard, I'm not a lawyer, but I think you need to change quite a bit.

Entertainment and experiment are 2 different things. Experimentally treating ailments is different from entertainment. Pick one wording or the other and stick to it.

Not sure what to cal the device but rife-like is not great.

I'm not sure what else.

[Russell Shipp]

Close. Let me touch it up .

Release Form for Rife Frequency Treatment – Revision 2

( note: recent additions/changes are shown in red)

I, _________________________ fully acknowledge the implications of the following six (6) paragraphs listed below; further, I fully understand, acknowledge, and accept the potential consequences either expressed or implied by these statements below.

1. I have received a “Rife-type” of device, Model # ___________________ (hereinafter referred to as “device”) on temporary loan, for a maximum period of _______ weeks, from ________________________ on the date ___________through _________. Further, while in my possession, I am responsible for the safe-keeping of this device.

2. I have been trained in the specific procedures that are to be used in connection with the safe operation of this device, and I have been trained in specific safety precautions that are to be followed, before, during and after the use of this device.

3. While in my possession, this device is to be used on an experimental basis by me only, and for the expressed experimental purpose of alleviating symptoms from and or causes of my own ailment(s), which I characterize as follows: ________________________________, __________________________, and _________________________________. (To All: Does this second portion of Paragraph # 3 sound OK to leave in, or should we delete any reference in this Release Form to "treatment of ailments"?)

4. Use of this device is for experimental purposes only; however, I realize that in the process of using this device, I may experience some possible physiological changes.

5. Though the maximum duration in my possession is specified in Paragraph # 1 as two (2) weeks, the device owner may request the return of this device after three (3) days.

6. The device owner is receiving no compensation of any kind for allowing me to borrow this device.

Signed below by the Owner and the Temporary User of this Device:


_______________________________________
Temporary User of Device Date

_______________________________________
Owner of This Device Date


Question to Forum Members: Does anyone have additional suggestions/ changes? Or is there another “template” other than this draft above that will suffice?
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5 and 6 could be whited out and or tweaked on this basis something could be loaned out and done up real nice..... Does anyone know if the carpenters grace has a release form they could share as a sample or template maybe? Compensation is an issue I leave up to anyone.. but yeah it is fine as it stands too in the quote.. I think that is a version I might start using Sans number 5 since two weeks is not the nomral amount of time it Takes for me tp heal up a sick person.... My clients tend to take 6 to 8 weeks to recover. Then again I tend to aim for the tougher ones...That is great up there... Who can improvwe upon it still further

[Richard Di Nucci]

Russell:

Sure, I'm happy to hand it over to you, Russell, if you wish.

First, I need to explain my rationale as to why I inserted paragraphs 5 & 6, and maybe some other folks might want to comment as well, based on their experience.

Paragraph 5 Rationale:
In a court of law, a binding agreement should have a specified term that is expressed in writing. I don't have a Rife machine, so I don't have any experience loaning out a device. While I believe a 2 week term might be excessive, in contracts that involve no remuneration, the party involved in loaning out their equipment without cost has the right to take it back prior to the end of the period, and should stipulate a circumstance(s) wherein (s)he might require the equipment to be returned. Further, this paragraph lends further credibility to the fact that this is a contract without compensation.

Paragraph 6 Rationale:
Paragraph 6 is the crux of a "no compensation" type of contract agreement. Since there is no remuneration, it is clear to a court that the Rife device owner is performing an act of kindness, based on mutual signatures. Without this paragraph, the owner of the Rife device is not on solid ground, and a plaintiff's attorney could claim there was some implied benefit to the Rife device owner.
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[CharBoehm]

Use of the words "treating, treat, or treatment" might inhibit some from using this document. Any word that has an implication of a medical procedure could end up being problematic.

Best wishes,
Char

[Richard Di Nucci]

Thanks, Char. That was helpful.

I am not familiar with which terms and phrases are sensitive, and which phrases are "not to be used" at all.

R
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[Russell Shipp]

Use of the words "treating, treat, or treatment" might inhibit some from using this document. Any word that has an implication of a medical procedure could end up being problematic.

Best wishes,
Char

Yes indeed. The words of soul anguishing gut twisting. ..... Treatment. Never say treatment.

I always tell my clients that after we are all done, if they are all cured, we are gonna praise jesus and go to church. The feds we'll just leave out of it.

[Richard Di Nucci]

Release Form for Rife Frequency Treatment – Revision 5

I, ______________________________ fully acknowledge the implications of the following seven (7) paragraphs listed below; further, I fully understand, acknowledge, and accept the potential consequences either expressed or implied by these statements below.

1. I have received an experimental Rife device, Model # ______________________ (hereinafter referred to as “device”) on temporary loan, for a period of two weeks, from ____________________________(name of device owner) on the date shown below. Further, while in my possession, I am responsible for the safe-keeping of this device.

2. I have been trained in the specific procedures that are to be used in connection with the safe operation of this experimental device, and I have been trained in specific safety precautions that are to be followed, before, during and after the use of this device.

3. This device will be used by me only, and I agree that I will not allow other persons to use it while it is in my possession.

4. Use of this device is for education and entertainment purposes only.

5. The duration when this device is in my possession is specified in Paragraph # 1 as two (2) weeks; however, the device owner may grant me additional time to use this device. Further, there may be occasions when the device owner may require this device while it is in my possession. In that event, the device owner will provide a 24 hour "advanced notice" to me, that the device must be returned on the following day.

6. The device owner is receiving no compensation of any kind for allowing me to borrow this device.

7. The Temporary User of this device has been advised to seek the counsel of a licensed medical practitioner if they believe that they are ill.


Signed below by the Owner and the Temporary User of this Device:


_______________________________________
Temporary User of Device Date

_______________________________________
Owner of This Device Date


Comment to Forum Members: Feel free to use this template, or modify it in whatever way you wish; if there is another template that has been used and found to be acceptable by Rifers, please provide info about it, or a link to it within this thread.