RSBell: print disclaimer
Posted on Friday, May 13, 2005 @ 15:40:02 EDT by rsbell
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PRIVATE LICENSE
Informed Consent, Disclaimer Statement and
Client/Co-worker Acknowledgement,
Contract and Agreement
Know All (Wo)Men by these Presents ~~
1. That whereas Robert Scott Bell has dedicated in excess of 12 (twelve)
years to the study and practice of homeopathic research and principles of
holistic healing and has been recognized as an expert health care provider in
the alternative/complementary healing community ~ ; and,
2. That whereas Robert Scott Bell has obtained professional training and
qualifications by successfully completing courses of the study at American
Academy of Clinical Homeopathy for the program in homeopathy ~ ; and,
3. That whereas any reference to Robert Scott Bell as a "doctor" is
in reference to its original meaning derived from Latin, which means teacher —
one who gives people the knowledge they need to facilitate their own healing
processes and achieve a state of well-being. ~ ; and,
4. That whereas Robert Scott Bell makes no claims, express OR implied, that
he is a medical doctor, physician, or any other term codified within the
statutes governing the "Practice of Medicine" in ANY state or
territory of the United States; and,
5. That whereas Robert Scott Bell has researched, formulated and taught
numerous courses in the theory and practice of the discipline of homeopathy,
including C.M.E. accredited courses to medical doctors and pharmacists; and,
6. That whereas Robert Scott Bell has served as a Board Member for the
American Association of Homeopathic Pharmacists from 1999-2001; and,
7. That whereas Robert Scott Bell has been continuously engaged in the
healing art of homeopathy since 1992, and there having been made no complaint to
a professional Board by any client/patient, their representative[s], or another
professional, nor has there in any interim been any lawsuit for damages nor
professional malpractice filed against the same Robert Scott Bell, nor against
his professional corporation at such times as his practice was conducted under
corporate limitations of liability; and,
8. That undersigned hereby grants a Private License to Robert Scott Bell to
engage in homeopathic, nutritional or other mutually agreeable modalities with
the undersigned; the undersigned acknowledges that Robert Scott Bell and his
agents do not diagnose or prescribe for medical or psychological conditions nor
claim to prevent, treat, mitigate or cure such conditions. Robert Scott Bell
does not provide diagnosis, care, treatment or
Initials:
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rehabilitation of individuals, nor does Robert Scott Bell apply medical,
mental health or human development principles, but rather provides therapeutic
modalities that may benefit the client/co-worker. The undersigned gives Informed
Consent to the services that will be provided. The undersigned hereby releases
Robert Scott Bell and his agents from all claims and liabilities arising from
the use or misuse of these modalities, indemnifying and holding Robert Scott
Bell and his agents harmless from all claims and liabilities there from
whatsoever. Robert Scott Bell reserves all rights.
9. That whereas professional malpractice insurance has been an expense which
has ultimately been unproductive, though that expense has had to be passed on to
the client/co-worker without benefit to either Robert Scott Bell or his
client/co-worker because of Robert Scott Bell’s diligence in providing the
highest quality and most professional services to his clientele; and, IN THE
PREMISES HEREINABOVE STATED ~~ It has been the decision of Robert Scott Bell to
terminate all malpractice insurance contracts and to so advise all current and
prospective clients/ co-workers of the execution of that decision and of the
fact that virtually no property, tangible nor intangible, is kept in his name,
nor is subject to any claim of liability which might be brought against the same
Robert Scott Bell, whether under Equity, Common Law, Commercial Law, nor
Admiralty.
Client/Co-worker Acknowledgement: therefore, for good and valuable
consideration, I acknowledge that:
I, _______________________________, have been made expressly aware that
Robert Scott Bell is not a medical doctor, nor is he engaged in the
practice of medicine. Further, he has made me aware that his services are in no
way represented to take the place of proper and appropriate medical care, as
deemed necessary by my primary-care physician (if any).
I, _______________________________, have read the above disclaimer statement
and choose to avail myself and/or my family members and/or ward[s] of the
services of Robert Scott Bell based upon his record of professional competence,
full disclosure, informed consent and with the full knowledge that any financial
recourse against the said Robert Scott Bell will necessarily be subject to the
conditions described above. In the event of any controversy, I and my heirs,
agents, and assigns, do hereby agree that resolution shall be had through the
services of a neutral arbiter whose decision shall be binding on all parties.
Done this ________ day of __________________, in the year, 200___, at
__________________, ___________ county, __________________.
_______________________________ Client/Co-worker or legal Guardian
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