Jernigan Nutraceuticals Patron Consent Declaration

I hereby consent to a holistically based phone consultation. Treatments recommended by Jernigan Nutraceuticals may utilize such substances as herbs, homeopathic remedies, vitamins, minerals, diet modifications, and various other therapeutic modalities, which will be determined by Dr. Sara Jernigan at Jernigan Nutraceuticals. This consultation, and the recommendations made by Jernigan Nutraceuticals, its employees, and any of its agents, are not meant to diagnose, treat, or cure “any specific disease.”

I understand that Jernigan Nutraceuticals is an herbal remedy company that believes that beating sickness requires addressing the whole person. Jernigan Nutraceuticals provides products that help bring the body back into maximum integrity to help it reach its optimal quality of life. As effective as our recommendations can be, there remains the possibility that many illnesses cannot be identified, treated, or cured. These would require specialized testing that is not offered by Jernigan Nutraceuticals. These methods and modalities are unconventional and adjunctive to primary diagnostic testing, lab work, etc.

I understand that I am responsible for the decision to seek a therapeutic program that includes the physical, psychological, environmental, and spiritual aspects of my illness. I understand that spiritual topics or Biblical principles may be discussed and applied, and counseling may be included as part of the consultation. I recognize that neither Dr. Sara Jernigan &/or Jernigan Nutraceuticals treat any specific disease or illness, but seek to optimize the performance of the human body. I recognize the possibility that this treatment plan may not prove successful.

I am fully informed that this approach to healing differs from, and may not be recognized by, traditional medical standards. I also understand that many of the therapies recommended by Jernigan Nutraceuticals may not be acceptable to doctors practicing traditional medicine. I understand that Medicare does not recognize homeopathy, energy medicine, non-prescription nutraceuticals, and lifestyle counseling, or any of the therapies recommended by Jernigan Nutraceuticals, its employees, or any of its agents. If I am a Medicare patient, I understand that I will not be covered for consultation, remedies, or therapy recommendations.

I understand that I am NOT considered a patient of Jernigan Nutraceuticals in any way. I understand and agree that any recommendations, including supplements and at-home therapies, made by Dr. Sara Jernigan and Jernigan Nutraceuticals are their best ideas based on the information available at the time and should not be considered a prescription, nor should Dr. Sara Jernigan &/or Jernigan Nutraceuticals be considered my health care provider.

As further inducement to Jernigan Nutraceuticals to provide recommendations &/or treatment for me, I hereby waive any claims and demands that I might now or hereafter have against Jernigan Nutraceuticals or its owners, employees, or agents that may arise, or deemed to arise from recommendations provided by Jernigan Nutraceuticals, and I hereby further release Jernigan Nutraceuticals and its owners, employees or agents from any and all liability of whatsoever kind or nature arising out of or in any way relating to the recommendations I will receive from Jernigan Nutraceuticals.

I understand that all information provided during phone consultations with Dr. Sara Jernigan and Jernigan Nutraceuticals is strictly confidential, and is to be used only in assessing recommended courses for treatment. This information is restricted to Dr. Sara Jernigan and myself based on my right to privacy. This information will not be transmitted to anyone else without my written permission.

Regardless of the jurisdiction in which this Consultation Declaration is signed by me, it shall be deemed to have been signed by me in the State of Kansas. Any dispute arising from, out of, or as a consequence of this Consultation Declaration or any recommendations provided by Jernigan Nutraceuticals shall be interpreted and construed in accordance with the laws of that jurisdiction. I hereby submit to the jurisdiction of the courts in the City of Wichita, Kansas, for the resolution of any dispute arising out of or relating to this Consultation Declaration and the recommendation given by Jernigan Nutraceuticals.

I understand that Jernigan Nutraceuticals reserves the right to deny consultation &/or service if it is not deemed by Jernigan Nutraceuticals to be in the best interest of the customer(s), staff, and/or Jernigan Nutraceuticals.

I agree to make prompt payment for all services rendered. I am not entitled to a refund for any consultation costs. Product purchased from Jernigan Nutraceuticals may be returned within 30 days ONLY if they are in their original condition with the seal intact. Jernigan Nutraceuticals does not assume responsibility for shipping & handling costs for the return of refunded products. Shipping & handling costs of original purchase will NOT be included in the refund amount.

It is understood that any remedies, nutritional supplements, or treatment recommendations are intended to enhance overall body performance and are not intended or implied to treat or “cure any specific illness.” It is understood that all remedies and nutritional supplements are only the doctor’s best recommendation and are at no time to be considered a prescription.

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