Free Medical Disclaimer Template
Medical Disclaimer
Please fill out this form to confirm your agreement to the terms and conditions.
Personal Information
Name
Date of Birth
Address
Phone number
Disclaimer
Please read and understand the following statements and check each box to confirm your understanding:
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I understand that the information and recommendations provided are for informational purposes only and not intended as medical advice.
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I acknowledge that no guarantees have been made to me regarding the results of any treatment or recommendations.
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I am aware that I should consult with a licensed healthcare professional before making any changes to my health routine.
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I understand that the service provider cannot be held responsible for any health-related decisions I make based on this information.
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I confirm that I have voluntarily chosen to engage with this service and take full responsibility for any outcomes.
Consent
By signing below, I have read, understand, and agree to the terms and conditions outlined above.
Name:
Date:
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