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Before my appointment, I certify that I am at least 18 years of age, of sound mental capacity, and understand and agree to the following:

My consultation with Dr. Anastasia Chopelas is not a medical evaluation, diagnosis, prescription, treatment, or prognosis (“medical care”) or a substitute for medical care or other licensed health care. Dr. Anastasia Chopelas, Scientific Healing®, and all persons acting in conjunction with them at the event at which this consultation occurs, or otherwise, are not medical or licensed health care practitioners; do not provide medical care or health care in connection with this consultation; do not make any representation or promise regarding the effects or outcome of this consultation; and do not in connection with this consultation assume responsibility for any medical or health condition that I now have or may have in the future. I will not, based on this consultation, modify, suspend, or stop any medical care or licensed health care I am now receiving or may receive in the future, without first consulting an appropriate medical or licensed health care practitioner responsible for that care.   I am not offering or replacing medical services. Our time together is to support your health, and does not replace your health care professional’s medical opinion.

I understand that the services provided fall under the California Senate Bill SB-577 allowing Dr. Chopelas to practice under the alternative health care services.

Anastasia Chopelas DOES NOT provide the following:
1. Conduct surgery or any other procedure on another person that punctures the skin or harmfully invades the body.

2. Administer or prescribes x-ray radiation to another person.

3. Prescribe or administers prescription drugs or controlled substances to another person.

4. Recommend the discontinuance of prescription drugs or controlled substances prescribed by an appropriately licensed practitioner.

5. Willfully diagnose and treats a physical or mental condition of any person under circumstances or conditions that cause or create risk of great bodily harm, serious physical or mental illness, or death.

6. Set fractures.

7. Treat lacerations or abrasions through electrotherapy.

8.  Hold out, states, indicates, advertises, or implies to a client or prospective client that she is a physician, a surgeon, or a physician and surgeon.

Anastasia Chopelas, Ph.D., is NOT A licensed physician. The treatment falls under the category of alternative or complementary to healing arts services licensed by the state.

Services Provided: Phone health consultations include: dietary advice, alternative methods to heal the body with lifestyle changes and diet, along with alternative energy healing . Consultations are not meant to replace medical visits and are meant to be complimentary to medical advice.

Theory: Consultations are based upon the work of Hippocrates, who believed vis medicatrix naturae – which I translate as “The Force of Nature Heals.” I believe that by aligning with nature’s principals that health of the body can be restored.

Education, training: Ph.D. Chemistry, MS, Geochemistry. Over 2000 hours of professional study in energy medicine, over 10,000 hours of intensive personal growth work related to the work including self-healing several middle aged maladies, 20 years practice of healing, thousands of successful outcomes.

Hold Harmless Agreement This material has been created solely for educational purposes. The author and publisher are not engaged in giving medical  advice or services. The author and publisher provide this information, and the client accepts it, with the understanding that everything done or tried as a result from this book, website, or from a phone consultation is at his or her own risk. The author and publisher shall have neither liability nor responsibility to any person or entity with respect to any loss, damage or injury caused, or alleged to be caused directly or indirectly by the information contained in her books, website or phone/personal discussion.

I have read and understand this document and authorize the consultation to which it pertains. This release and waiver is part of the consideration to Dr. Anastasia Chopelas for this consultation, and Dr. Chopelas would not provide this consultation without this release and waiver.

On behalf of myself, and my heirs, representatives, successors, and assigns, I release and waive any and all claims in connection with this consultation that I or they now have or may have in the future against Dr. Anastasia Chopelas, Scientific Healing®; the employees, contractors, and agents of Dr. Anastasia Chopelas and/or Scientific Healing® all persons and organizations advising, promoting, sponsoring, hosting, or otherwise involved with the event at which this consultation occurs; and their heirs, representatives, successors and assigns.

If you understand and agree with the terms of this agreement, click the “Accept” button. Then wait a few seconds while you are re-directed to Dr. Anastasia’s calendar.

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