Disclaimer, Disclosure and Consent Form

The purpose of this form is to acknowledge that we are creating a working relationship, and that you consent to proceed with a hair mineral analysis and a Mineral-Nutritional Balancing program.

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I request that Rosemary Slade perform a hair mineral analysis and set up a Mineral-Nutritional Balancing program.


I also understand that Mineral-Nutritional balancing is not a substitute for regular medical care. Mineral- Nutritional Balancing is not a means of diagnosis, treatment, prescription, medical advice or cure for any disease or condition, mental or physical. Instead, it is a means of reducing stress and balancing, strengthening, and restoring body chemistry.


Rosemary Slade has extensively studied nutrition, diet, and health. She has received her

Nutritional Balancing Science Diploma from Westbrook University and is certified as a Mineral Nutritional Balancing Practitioner.


I understand that there are no refunds.


I accept full responsibility for my health care, and I maintain my right to my personal freedom of choice and decision making regarding any health improvement practices that I choose to receive. I also understand that I can choose not to participate with mineral nutritional balancing and Rosemary Slade at any time.


As a sovereign being, I am capable of choosing those procedures that I consider useful to me and that have the potential to improve my life. I understand that no health care screening, resulting conclusions or any health care services are foolproof, and I accept the risks and take full self-responsibility for that which I consent to.


I understand that Rosemary Slade will make recommendations about lifestyle changes, diet changes and detoxification protocols and I can choose to participate with any or all of these suggestions.


I enter this relationship with Rosemary Slade regarding mineral nutritional balancing with my own free will, without any pressure or promise.

I understand that Rosemary Slade is not a medical doctor, nor does she provide medical opinions, advice, assessments, or consultations. I understand that if I want a medical opinion, I will seek out a medical professional.


By entering my name, I accept the terms above and want Rosemary Slade to perform a hair mineral analysis and set up a Mineral-Nutritional Balancing program.

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