MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services and care, do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association no doctor-patient relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosis, therapy, treatment and care is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosis, therapy, treatment and care is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such care, except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees and members have chosen Xx. Xxxx Xxxx Tai as the person best qualified to perform services to members of the Association and entrust them to select other members to assist her in carrying out that service. In addition, I understand that, since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicable. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, and other providers who are fellow members of the Association are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State or Federal agency whose purpose is to regulate and approve products. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time. These pages and Article I of the articles of association of the Association consist of the entire agreement for my membership in the Association and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of $49.95 as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Contractual Application for Membership and I fully understand and agree with same.
Appears in 2 contracts
Samples: Brasil American, Brasil American
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services health assessment, therapy, treatment and care, products, electronic instruments, etc., do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association Association no doctor-patient relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client patient to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risksrisk, and desirability of same and the acceptance of the offered or recommended diagnosisnutrition, health assessment, therapy, treatment and care care, products, subtle energy devices and electronic instruments, etc., is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosisnutrition, health assessment, therapy, treatment and care care, products, subtle energy devices and electronic instruments, etc., is my own free decision in an exercise of my rights and made by me for my benefit, benefit and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such care, etc., except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees Trustee and members have chosen Xx. Xxxx Xxxx Tai Xxxxxxx as the person best qualified to perform healthcare services to members of the Association and entrust them him to select other members to assist her him in carrying out that service. In addition, I understand that, since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of medical membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare Healthcare records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member member, but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicable. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, nurses and other providers who are fellow members of the Association are offering me advice, services, services and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, care or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo forego drugs, surgery, surgery or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, and Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State state or Federal federal agency whose purpose is to regulate and approve productsthe practice of medicine. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time. These pages and Article I of the articles of association of the Association consist of the entire agreement for my membership in the Association and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose agree to the sum charge of $49.95 10.00 as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Salt Lake Homeopathy Contractual Application for Membership and I fully understand and agree with same.
Appears in 1 contract
Samples: www.saltlakehomeopathy.com
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association Foundation that provide services education along with products that nourish and care, nurture my inner physician do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association no doctor-doctor- patient relationship exists but only a contract member-member Association relationship. In addition, relationship and I have freely chosen to change my legal status as a public patient, customer patient or client to a private member of the Association. I further understand that it is entirely my own responsibility to consider ask my Primary Health Care Physician before considering the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosis, therapy, treatment and care treatment, care, modality products is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosis, therapy, treatment and care treatment, care, modality and/or products is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s), staff and other worker members and the Foundation/Association harmless from any unintentional liability for the results of such care, except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, Association and as stated and defined by the United States Supreme Court. The Co-Trustees CellularHealth Foundation and members have chosen Xx. Xxxx Xxxx Tai Xxxxxxxx Xxxxx as the person persons best qualified to perform services oversee Inner physician enhancement programs to members of the Association Foundation and entrust them him to select other members to assist her in him carrying out that service. duty (i.e. medical doctors, oncologists, naturopathic doctors, research scientists, etc.) In addition, I understand that, that since the Association CellularHealth Foundation is protected by the First 1st and Fourteenth Amendments to 14th amendments of the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association CellularHealth Foundation and its members. Because the privacy and security of membership records maintained within the Association Foundation, which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare records kept by the association will be strictly protected and only released upon written request approval of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association CellularHealth Foundation does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicablemembers. I agree to join the CellularHealth Foundation (Association), a private membership association under common law, whose members seek stated purpose is to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, and other providers who are fellow members of the Association are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include a medical “cure”, on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might are not be covered by my health insurance and not at all or by Medicaregovernment insurance. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, surgery or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Associationassociation members. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the AssociationCellularHealth Foundation, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the AssociationCellularHealth Foundation, unless that member has exposed proved to me to be a clear and present danger of substantive evil. I acknowledge that the members of the Association CellularHealth Foundation do not carry malpractice insurance. , thus I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State state or Federal federal agency whose purpose is to regulate and approve productsthe practice medicine. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association the CellularHealth Foundation at any timetime in writing. These pages and Article I of the articles 6 Articles of association of the Association consist of the entire agreement for my association membership in the Association and they supersede any previous agreementagreements expressed or otherwise implied. I understand that the lifetime membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees Trustee(s) to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of $49.95 89.95 as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing of this contract, and by these presents witnesses present, I do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Contractual Application for Membership Membership, and I fully understand and agree with same.it in its entirety. This agreement is executed at ,on the , 2013, and is subject to the State of Florida. Signed by: day of (Print Name and address of New Member) Witnesses (Sign and print name below):
Appears in 1 contract
Samples: cellularhealth.org
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services products, education, nutritional counseling and care, care do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association no doctor-patient relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client patient to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosistherapy and care, therapy, treatment and care etc. is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosistherapy and care, therapy, treatment and care etc. is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such care, etc., except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees and members have chosen Xx. Xxxx Xxxx Tai Xxxxxxx Xxxxxxxxx, Doctor of Natural Medicine and Xxxxx Xxx Xxxxxxxxx, Xx. as the person persons best qualified to perform health services to members of the Association and entrust them to select other members to assist her them in carrying out that service. In addition, I understand that, that since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of medical and health membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare Medical records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member member, but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicable. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, and other providers who are fellow members of the Association are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State state or Federal federal agency whose purpose is to regulate and approve productsthe practice of medicine. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any timetime by sending a written notice of termination to xxxxx@XX000.xxx. These pages and Article I of the articles Articles of association Association of the Association consist of the entire agreement for my membership in the Association Association, and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of ten dollars ($49.95 10.00) as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Protect Your Earth SuitTM/LT360 Holistic HealthTM’s Contractual Application for Membership Membership, and I fully understand and agree with same.
Appears in 1 contract
Samples: Protect Your Earth Suittm
MEMORANDUM OF UNDERSTANDING. The relationship between members: I understand that the fellow members of the Association that who provide services and care, care do so in the capacity of a fellow member and not in the capacity as of a licensed health care healthcare provider, licensed attorney, licensed tax professional. I further understand that within the association society no doctor-patient relationship relationship, or attorney-client privilege exists but only a contract member-member Association collective relationship. In addition, I have freely chosen to change my legal status as a public patient, customer customer, client, or client member of the public to that of a private member of the AssociationSociety. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosisrecommended, advice, counsel, therapy, treatment and care is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosisadvice, counsel, therapy, treatment and treatment, service and/or care is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s)Trustees, staff and other worker members and the Association Society harmless from any unintentional liability for the results of such caresuch, except for harm that results from instances of a clear and present danger that raises to the level of substantive evil with malicious intent as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees and members have chosen Xx. Xxxx Xxxx Tai as the person best qualified to perform services to members of the Association and entrust them to select other members to assist her in carrying out that serviceSociety. In addition, I understand that, since the Association Society is protected by the First and Fourteenth Amendments to the U.S. ConstitutionGod’s Law, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the AssociationSociety, any Trustee(s), members or other staff personsmembers. All rights of complaints or grievances will shall only be settled by an Association Committee and will be waived internal committee established by the member Trustees of The Collective of San Antonio. Therefore, for the benefit of the Association society and its members, I agree not to seek any remedy for relief in the Public Domain. Because I agree that my violation of any part of this member agreement would result in a no contest legal proceeding against me, including fines and penalties as determined by The Collective of San Antonio and in accordance with the Bylaws of The Collective of San Antonio. The privacy and security of membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme CourtSociety, the undersigned member waives HIPAA privacy rights and complaint process. Any medical including any medical, healthcare, or healthcare records legal records, data, scans, surveys, analyses, tests, results, statements, forms, reports, or samples kept by the association society will be strictly protected and only released upon written request of the member. I agree that violation , and not to be shared or sold in the public domain without express written consent of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, both the Association does not participate in any medical insurance plans or collections on behalf of Society and the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicablemember. I agree to join the AssociationSociety, a private membership association Private Ecclesiastic Research Society, and contract under common lawthe Common Law of Contracts, whose with other members that also seek to help each other achieve better health and live longer with good quality of life. I understand that the doctorsprofessionals, nursespractitioners, and other providers who are fellow members of the Association Society are offering me advice, services, and benefits that do not necessarily conform to conventional medical carepractice, I fully agree not to file a lawsuit malpractice, civil, or any other suit against a fellow member of the Society, unless that member has maliciously forced me to a “clear and present danger that rises to the level of substantive evil” of “criminal intent”. I do acknowledge that the members of the Society may not expect these benefits to include on-call coveragecarry malpractice or liability insurance. No member will intentionally cause any other member of the Society harm be it physical, hospital carespiritual, emotional, or the usual and customary care provided by most physiciansfinancial. If such a danger arises, I will receive such primary and specialist care elsewhere. I fully understand that make a grievance report to the benefits I receive from Society for an equitable decision against the Association might or might not be covered by my health insurance and not at all by Medicareother member(s). As a member, I accept the goals of helping my brain and body function better and choosing information and techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to conventional approaches to managing my health and business, such as to forgo drugs, surgery, or radiation that has been recommended to me by others, or conduct ones business affairs privately outside of the public domain, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the AssociationSociety. I accept full and complete responsibility for my own life, and my own consequences for my own decisions in my journey for life, liberty, and my personal private pursuit of happiness. My activities within the Society are a private matter and I lawfully refuse to share with the Public Domain, State Medical Board, my own insurance company or any other public corporation, including government agencies without both my express permission and that of the Society. All records and documents remain as property of the Society, even if I receive a copy of them. Any disclosure on my part of any information provided to me by the Society will constitute a violation of this membership agreement. I understand that members, teachers, instructors, educators, doctors, lawyers, nurses, and other service providers within The Collective of San Antonio are or may not be licensed educators, teachers, instructors, doctors, lawyers, nurses, or coaches. I understand that within The Collective of San Antonio a private contractual relationship exists as a contract member to member collective relationship. I have freely chosen to become a private member of The Collective of San Antonio. In joining the Society, I hereby change my legal capacity as that of a public person, customer, or client to a private member of The Collective of San Antonio. I understand that the Society is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Society, any Trustee(s), or member(s). All rights of complaints or grievances will be settled by a designee, committee, or tribunal appointed by the Trustees of the Society. By agreeing to this member agreement I agree that I have sought sufficient education to determine that this is the course of action I want to take for myself and my children. I agree that violation of this membership contract will result in a no contest legal proceeding against me, including but not limited to liens and fines placed against myself and my property as a result of my violation of this membership contract, and therefore I acknowledge and consent that any breach of this Agreement on my part shall result in a judgment in favor of the Society in the amount of ten million dollars ($10,000,000), which shall be immediately due and payable on demand. Other aspects of informed consent may take place in my discussions with the providers and my fellow members of the Society. As I am voluntarily choosing this method of education and service providers, I will not hold The Association or its members financially liable for any particular outcome. I agree to join The Collective of San Antonio, a Private Ecclesiastic Research Society under common law, whose members seek to help each other achieve better health, education, and good quality of life. My activities within the Society are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company any public agency without my expressed specific permission. All records and documents remain as property of the AssociationSociety, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit pursue any course of legal action against a fellow member of the AssociationSociety, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that , and upon the members recommendation and approval of the Association do not carry malpractice insuranceSociety. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of curecoercion. I affirm that that, as a private member I do not represent any Local, State or Federal agency whose purpose is to regulate and approve products, services, or practices, or to carry out any mission of enforcement, entrapment or investigation. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time, and that my membership can and will be revoked if I engage in abusive, violent, menacing, problematic, destructive or harassing behavior towards any other member. These pages and Article I of the articles of association of the Association consist of the entire agreement for my membership in the Association. As a member of The Collective of San Antonio, I acknowledge and agree that it is my responsibility to regularly review and stay informed of any changes or updates to these terms of membership. The Collective of San Antonio may modify, amend, or revise these terms and conditions at its discretion, and such changes will be effective immediately upon posting on the website or platform of The Collective of San Antonio. It is my duty to periodically check for updates and to comply with the most current version of these terms and conditions. Payment of any dues, fees, or program costs, if applicable, and delivery of these signed documents to a representative of the Society is considered sufficient for membership contract. Term begins with the date of submission of this contract. Member’s free will and agreement: I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of a cure, remedy, or solution. I affirm that I do not represent any State or Federal agency or corporation whose purpose is to regulate the practice of law, or medicine and/or approve products for the public only. I have read and understood this document, and my questions have been answered fully to my satisfaction. These pages and Article 13 of the Articles of Association of this Society consist of the entire agreement for my membership in the Society and they supersede any previous agreement. Terms of agreement and cancellation: I understand that I can withdraw from this agreement and terminate my membership in this Society at any time. Canceling my membership, in no way (a.) waives the membership fee entitles me adherence to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products terms and services are final, no exchange or refund. I enclose the sum of $49.95 as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing conditions of this contract, (b.) refunds the annual membership fees, nor (c.) cancels any private contract entered into between myself and other private members. I understand that my membership will auto-renew on the annual anniversary date of my membership and will continue to auto-renew until I decide to cancel, xxxxxxx@xxxxxxx-xx.xxx which I can do at any time by these presents do hereby certifyemailing with the subject line “PMA Renewal Cancelation Request” or in writing to The Collective of San Antonio c/o 8121 Xxxxxxxxx San Antonio, attest and warrant that Texas 78230 at least 14 business days prior to auto-renewal. I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Contractual Application for Membership and understand not renewing my membership will suspend membership status but not cancel membership until I fully understand and agree with samevoluntarily request to cancel in writing.
Appears in 1 contract
Samples: Contractual Member Agreement
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members Director of the Association that provide services and carePMA provides services, do so sales or advice in the capacity of a fellow member Member Facilitator in a private manner and not in the capacity as a licensed health care providerany public capacity. I further understand that within the association no doctor-patient relationship exists but only PMA, all members are equal. Understanding that this is a contract member-member Association relationship. In additionPrivate Membership Association, I have freely chosen to change my legal status as a public patient, customer or client to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosis, therapy, treatment and care is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosis, therapy, treatment and care is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold harmless the Trustee(s), staff PMA and the Director and other worker members and the Association harmless Members from any unintentional liability for that might result from the results of such careadvice or services I receive, except for from any harm that results from instances of could remotely result “a clear and present danger of substantive evil evil” as determined by the Association, as stated PMA and defined by the United States Supreme Court. The Co-Trustees and members have chosen Xx. Xxxx Xxxx Tai as the person best qualified to perform services to members of the Association and entrust them to select other members to assist her in carrying out that service. In addition, I understand thatthat the PMA is exempt from any action of Federal, since the Association is protected by the First and Fourteenth Amendments State or Local agencies as it relates to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the AssociationPMA, any Trustee(s), members its Director or other staff personsMembers. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of membership records maintained non-judicial arbitration within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicable. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, and other providers who are fellow members of the Association are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurancePMA. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of curewill. I affirm accept that this Membership does not entitle me to any voting interest in the PMA. I do acknowledge I am not represent liable for any State debts, liabilities, suits or Federal agency whose purpose is to regulate and approve productsjudgments against the PMA. I understand that this Membership does not absolve me from any personal obligation outside of this Association. I have read and understood understand this document, contract and my any questions have been I had were answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate This document consists of my membership in this association at any time. These pages and Article I of the articles of association of the Association consist of the entire agreement for my membership in the Association Membership and they supersede it supersedes any previous agreementagreement I may have made, either express or implied. I understand that the membership fee my Membership fee, if any, entitles me to receive those benefits declared by the Trustee(s) Executive Director of the PMA to be “general benefits” free of further charge. I agree to understand that my membership fee, if any, does not pay as levied those benefits that I receive that are declared for the shells or other items sold by the Trustees to be “special assessments”, per Fee SchedulePMA. I also understand that all sales The term of products and services are final, no exchange or refund. I enclose the sum of $49.95 as consideration for my one-time lifetime membership contract, said term beginning with Membership begins on the date of upon which I create my Membership and continues until the signing dissolution of this contractAssociation. By creating my Membership and autographing below, I do certify and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Contractual Application this application for Membership and I fully understand and agree with same.all the provisions stated herein. Accepted by: a Man/Woman, as Member Date: Address: Email:
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Samples: www.algoabayshells.com
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services products, education, nutritional counseling and care, care do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association no doctor-patient relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client patient to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosis, therapy, treatment and care care, etc. is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosis, therapy, treatment and care care, etc. is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such care, etc., except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees Trustee and members have chosen Xx. Xxxx Xxxx Tai XXXXXX XXXXX as the person best qualified to perform health services to members of the Association and entrust them her to select other members to assist her in carrying out that service. In addition, I understand that, that since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of medical and health membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare Medical records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member member, but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicable. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, and other providers who are fellow members of the Association are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State state or Federal federal agency whose purpose is to regulate and approve productsthe practice of medicine. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time. These pages and Article I of the articles Articles of association Association of the Association consist of the entire agreement for my membership in the Association Association, and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of $49.95 20.00 as consideration for my one-time lifetime yearly membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Live Your B.E.S.T.’s Contractual Application for Membership Membership, and I fully understand and agree with same.
Appears in 1 contract
Samples: liveyour-best.com
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services and care, do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association no doctor-patient relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosis, therapy, treatment and care is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosis, therapy, treatment and care is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such care, except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees Trustee and members have chosen Xx. Xxxx Xxxx Tai Xxxxxxx Xxxxx Xxxxxx as the person best qualified to perform services to members of the Association and entrust them to select other members to assist her in carrying out that service. In addition, I understand that, since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicable. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, and other providers who are fellow members of the Association are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State or Federal agency whose purpose is to regulate and approve products. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time. These pages and Article I of the articles of association of the Association consist of the entire agreement for my membership in the Association and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of $49.95 10.00 as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) HEALTH RESTORATION Contractual Application for Membership and I fully understand and agree with same.
Appears in 1 contract
Samples: drkellymiller.com
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide products, consultations, services and care, do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association no doctor-patient relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosis, therapy, treatment and care is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosis, therapy, treatment and care is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such care, except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees and members have chosen Xx. Xxxx Xxxx Tai Xxxxxxx (Xxxx) Xxxxxx Xxxxx as the person best qualified to perform services to members of the Association and entrust them him to select other members to assist her him in carrying out that servicethose services. In addition, I understand that, that since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies agencies and Authorities authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of membership records maintained within the Association Association, which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA HIPPAA privacy rights and the complaint process. Any medical or healthcare records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicable. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, nurses and other providers who are fellow members of the Association are offering me advice, servicesproducts, services and benefits that do not necessarily conform to conventional medical or health care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry liability or malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State or Federal agency whose purpose is to regulate and approve products. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time. These pages and Article I of the articles Articles of association Association of the Association consist of the entire agreement for my membership in the Association and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of $49.95 10.00 as consideration for my one-time lifetime annual membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Getting Well Naturally’s Contractual Application for Membership and I fully understand and agree with same.
Appears in 1 contract
Samples: gwn-phma.com
MEMORANDUM OF UNDERSTANDING. The relationship between members: I understand that the fellow members of the Association that who provide services and care, care do so in the capacity of a fellow member and not in the capacity as of a licensed health care healthcare provider, licensed attorney, licensed tax professional. I further understand that within the association society no doctor-patient relationship relationship, or attorney-client privilege exists but only a contract member-member Association collective relationship. In addition, I have freely chosen to change my legal status as a public patient, customer customer, client, or client member of the public to that of a private member of the AssociationSociety. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosisrecommended, advice, counsel, therapy, treatment and care is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosisadvice, counsel, therapy, treatment and treatment, service and/or care is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s)Trustees, staff and other worker members and the Association Society harmless from any unintentional liability for the results of such caresuch, except for harm that results from instances of a clear and present danger that raises to the level of substantive evil with malicious intent as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees and members have chosen Xx. Xxxx Xxxx Tai as the person best qualified to perform services to members of the Association and entrust them to select other members to assist her in carrying out that serviceSociety. In addition, I understand that, since the Association Society is protected by the First and Fourteenth Amendments to the U.S. ConstitutionGod’s Law, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the AssociationSociety, any Trustee(s), members or other staff personsmembers. All rights of complaints or grievances will shall only be settled by an Association Committee and will be waived internal committee established by the member Trustees of The Collective of San Antonio. Therefore, for the benefit of the Association society and its members, I agree not to seek any remedy for relief in the Public Domain. Because I agree that my violation of any part of this member agreement would result in a no contest legal proceeding against me, including fines and penalties as determined by The Collective of San Antonio and in accordance with the Bylaws of The Collective of San Antonio. The privacy and security of membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme CourtSociety, the undersigned member waives HIPAA privacy rights and complaint process. Any medical including any medical, healthcare, or healthcare records legal records, data, scans, surveys, analyses, tests, results, statements, forms, reports, or samples kept by the association society will be strictly protected and only released upon written request of the member. I agree that violation , and not to be shared or sold in the public domain without express written consent of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, both the Association does not participate in any medical insurance plans or collections on behalf of Society and the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicablemember. I agree to join the AssociationSociety, a private membership association Private Ecclesiastic Research Society, and contract under common lawthe Common Law of Contracts, whose with other members that also seek to help each other achieve better health and live longer with good quality of life. I understand that the doctorsprofessionals, nursespractitioners, and other providers who are fellow members of the Association Society are offering me advice, services, and benefits that do not necessarily conform to conventional medical carepractice, I fully agree not to file a lawsuit malpractice, civil, or any other suit against a fellow member of the Society, unless that member has maliciously forced me to a “clear and present danger that rises to the level of substantive evil” of “criminal intent”. I do acknowledge that the members of the Society may not expect these benefits to include on-call coveragecarry malpractice or liability insurance. No member will intentionally cause any other member of the Society harm be it physical, hospital carespiritual, emotional, or the usual and customary care provided by most physiciansfinancial. If such a danger arises, I will receive such primary and specialist care elsewhere. I fully understand that make a grievance report to the benefits I receive from Society for an equitable decision against the Association might or might not be covered by my health insurance and not at all by Medicareother member(s). As a member, I accept the goals of helping my brain and body function better and choosing information and techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to conventional approaches to managing my health and business, such as to forgo drugs, surgery, or radiation that has been recommended to me by others, or conduct ones business affairs privately outside of the public domain, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the AssociationSociety. I accept full and complete responsibility for my own life, and my own consequences for my own decisions in my journey for life, liberty, and my personal private pursuit of happiness. My activities within the Society are a private matter and I lawfully refuse to share with the Public Domain, State Medical Board, my own insurance company or any other public corporation, including government agencies without both my express permission and that of the Society. All records and documents remain as property of the Society, even if I receive a copy of them. Any disclosure on my part of any information provided to me by the Society will constitute a violation of this membership agreement. I understand that members, teachers, instructors, educators, doctors, lawyers, nurses, and other service providers within The Collective of San Antonio are or may not be licensed educators, teachers, instructors, doctors, lawyers, nurses, or coaches. I understand that within The Collective of San Antonio a private contractual relationship exists as a contract member to member collective relationship. I have freely chosen to become a private member of The Collective of San Antonio. In joining the Society, I hereby change my legal capacity as that of a public person, customer, or client to a private member of The Collective of San Antonio. I understand that the Society is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Society, any Trustee(s), or member(s). All rights of complaints or grievances will be settled by a designee, committee, or tribunal appointed by the Trustees of the Society. By agreeing to this member agreement I agree that I have sought sufficient education to determine that this is the course of action I want to take for myself and my children. I agree that violation of this membership contract will result in a no contest legal proceeding against me, including but not limited to liens and fines placed against myself and my property as a result of my violation of this membership contract, and therefore I acknowledge and consent that any breach of this Agreement on my part shall result in a judgment in favor of the Society in the amount of ten million dollars ($10,000,000), which shall be immediately due and payable on demand. Other aspects of informed consent may take place in my discussions with the providers and my fellow members of the Society. As I am voluntarily choosing this method of education and service providers, I will not hold The Association or its members financially liable for any particular outcome. I agree to join The Collective of San Antonio, a Private Ecclesiastic Research Society under common law, whose members seek to help each other achieve better health, education, and good quality of life. My activities within the Society are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company any public agency without my expressed specific permission. All records and documents remain as property of the AssociationSociety, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit pursue any course of legal action against a fellow member of the AssociationSociety, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that , and upon the members recommendation and approval of the Association do not carry malpractice insuranceSociety. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of curecoercion. I affirm that that, as a private member I do not represent any Local, State or Federal agency whose purpose is to regulate and approve products, services, or practices, or to carry out any mission of enforcement, entrapment or investigation. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time, and that my membership can and will be revoked if I engage in abusive, violent, menacing, problematic, destructive or harassing behavior towards any other member. These pages and Article I of the articles of association of the Association consist of the entire agreement for my membership in the Association. As a member of The Collective of San Antonio, I acknowledge and agree that it is my responsibility to regularly review and stay informed of any changes or updates to these terms of membership. The Collective of San Antonio may modify, amend, or revise these terms and conditions at its discretion, and such changes will be effective immediately upon posting on the website or platform of The Collective of San Antonio. It is my duty to periodically check for updates and to comply with the most current version of these terms and conditions. Payment of any dues, fees, or program costs, if applicable, and delivery of these signed documents to a representative of the Society is considered sufficient for membership contract. Term begins with the date of submission of this contract. Member’s free will and agreement: I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of a cure, remedy, or solution. I affirm that I do not represent any State or Federal agency or corporation whose purpose is to regulate the practice of law, or medicine and/or approve products for the public only. I have read and understood this document, and my questions have been answered fully to my satisfaction. These pages and Article 13 of the Articles of Association of this Society consist of the entire agreement for my membership in the Society and they supersede any previous agreement. Terms of agreement and cancellation: I understand that I can withdraw from this agreement and terminate my membership in this Society at any time. Canceling my membership, in no way (a.) waives the membership fee entitles me adherence to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products terms and services are final, no exchange or refund. I enclose the sum of $49.95 as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing conditions of this contract, (b.) refunds the annual membership fees, nor (c.) cancels any private contract entered into between myself and other private members. I understand that my membership will auto-renew on the annual anniversary date of my membership and will continue to auto-renew until I decide to cancel, xxxxxxx@xxxxxxx-xx.xxx which I can do at any time by these presents do hereby certifyemailing with the subject line “PMA Renewal Cancelation Request” or in writing to The Collective of San Antonio c/o 8121 Xxxxxxxxx San Antonio, attest and warrant that Texas 78249 at least 14 business days prior to auto-renewal. I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Contractual Application for Membership and understand not renewing my membership will suspend membership status but not cancel membership until I fully understand and agree with samevoluntarily request to cancel in writing.
Appears in 1 contract
Samples: Contractual Member Agreement
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services products, education, nutritional counseling and care, care do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association no doctor-patient relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client patient to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosistherapy and care, therapy, treatment and care etc. is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosistherapy and care, therapy, treatment and care etc. is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such care, etc., except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees Trustee and members have chosen Xx. Xxxx Xxxx Tai Xxxxxxx Xxxxxx x’Xxxxxx as the person best qualified to perform health services to members of the Association and entrust them him to select other members to assist her them in carrying out that service. In addition, I understand that, that since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of medical and health membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare Medical records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in or provide coded forms for any medical government or commercial insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicableprogram. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, and other providers who are fellow members of the Association are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might are not be covered by my health insurance and not at all by insurance, Medicaid or Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State state or Federal federal agency whose purpose is to regulate and approve productsthe practice of medicine. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time. These pages and Article I of the articles Articles of association Association of the Association consist of the entire agreement for my membership in the Association Association, and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of Ten Dollars ($49.95 10.00) as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) ParaWellness Research’s Contractual Application for Membership Membership, and I fully understand and agree with same.
Appears in 1 contract
Samples: parawellnessresearch.com
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services products, services, care and careeducation, do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association no doctor-patient relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosis, assessment, therapy, treatment and care is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosis, assessment, therapy, treatment and care is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s), staff and other worker worker/staff members and the Association harmless from any unintentional liability for the results of such care, except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees Trustee and members have chosen Xx. Xxxx Xxxx Tai Xxxxxx X Xxxxxxxxx XX as the person best qualified to perform services to members of the Association and entrust them him to select other members to assist her him in carrying out that service. In addition, I understand that, since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member who has received paid services from the Association, to pursue reimbursement by his/her insurance company, if applicable. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, and other non-licensed providers who are fellow members of the Association are offering may offer me advice, services, education, and other benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the assigned member service providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company company, or any other governmental or medical agency without my expressed specific permissionpermission from the current Association Trustee, Association President, or Association Vice President. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State or Federal agency whose purpose is to regulate and approve productsproducts or regulate the practice of medicine. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association in writing at any timetime without any financial refund. These pages and Article I of the articles of association of the Association consist of the entire agreement for my membership in the Association and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of $49.95 10.00 USD as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Seriously Smart Technologies, Contractual Application for Membership and I fully understand and agree with same.
Appears in 1 contract
Samples: Membership Contract
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services and care, do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association no doctor-patient relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosis, therapy, treatment and care is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosis, therapy, treatment and care is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such care, except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees and members have chosen Xx. Xxxx Xxxx Tai as the person best qualified to perform services to members of the Association and entrust them to select other members to assist her him in carrying out that service. In addition, I understand that, since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicable. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, and other providers who are fellow members of the Association are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State or Federal agency whose purpose is to regulate and approve products. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time. These pages and Article I of the articles of association of the Association consist of the entire agreement for my membership in the Association and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of $49.95 10.00 as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Contractual Application for Membership and I fully understand and agree with same.. Products have NO WARRANTIES, either expressed or implied, that can affect any human conditions. For general safety we DO NOT accept any RETURNS or EXCHANGES. ALL SALES ARE FINAL, WE DO NOT ACCEPT RETURNS OR REFUNDS OF PRODUCTS OR TESTING. IN WITNESS WHEREOF I set my hand this day of , 20 . _ Member’s Name (Please Print Legibly) (and name of legal guardian if applicant under 18 years) Member’s Signature (and signature of legal guardian if applicant under 18 years) Street City State Zip Code Home/Work/Cell #s Email address Trustee Signature; Approval Date
Appears in 1 contract
Samples: Brasil American
MEMORANDUM OF UNDERSTANDING. I understand that the fellow those members of the Association Academy that provide services and care, or advice do so in the capacity of fellow member-facilitators in a fellow member private manner and not in the capacity as a licensed health public health-care providerproviders. I further understand that within the association Academy no doctorPublic-patient Doctor-Patient or Public-Therapy-Client relationship exists but only a contract member-member Association relationshipexists. In additionWithin the Academy, I have freely chosen choose to change my legal status as from that of a public patientPublic Health-Care. Recipient, customer or client to that of a private member of the AssociationPrivate Membership Academy care recipient. I further realize that in doing so I relinquish certain Federal and State protections and privileges. I understand that it is entirely my own personal responsibility to consider evaluate the advice and recommendations services offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and or desirability. I agree that the acceptance of the offered or recommended diagnosisactions I take, therapyin this regard, treatment and care is are my own carefully considered decisionfree-will decisions. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosisIf I am accepted for membership, therapy, treatment and care is I will exercise my rights for my own free decision in an exercise of my rights benefit and made by me for my benefit, and I agree to hold harmless the Trustee(s), staff Academy and other worker members and the Association harmless member- facilitators from any unintentional liability for that might result from the results of such careadvice or services I receive, except for the harm that results could remotely result from instances an instance of “a clear and present danger of substantive evil evil” – as determined by the Association, Academy and as stated and defined by the United States Supreme Court. The Co-Trustees and members have chosen Xx. Xxxx Xxxx Tai as the person best qualified to perform services to members of the Association and entrust them to select other members to assist her in carrying out that service. In addition, I understand and accept that, since the Association Academy is protected by the First First, Ninth and Fourteenth Amendments to the U.S. United States Constitution, it is outside the jurisdiction and authority exempt from any action of Federal and State Agencies and Authorities concerning agencies entrusted to “protect the public” – as it relates to any and all complaints or grievances against the AssociationAcademy, any Trustee(s)its physical premises or equipment, members its Trustees, member-facilitators or other associated staff personsor consultants. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of membership records maintained no-judicial mediation, within the Association which have been held to be inviolate by the U.S. Supreme CourtAcademy. Also, the undersigned those membership and private member waives HIPAA privacy rights and complaint process. Any medical or healthcare records kept by the association will be Academy are strictly protected and can only be released upon written request of the subject member. I agree that violation of any waivers in I am joining this membership contract will result in a no contest legal proceeding against me. In addition, Private Membership Academy under the Association does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicablecommon law. I agree to join the Association, a private membership association under common law, whose understand that members seek to help each other achieve and sustain better health and live longer with good quality of lifehealth. I understand accept that the doctors, nursesfacilitators, and other providers health –care providers, who are fellow members of the Association are offering me members, offer advice, services, and benefits that do are not necessarily conform conventional or traditional. As a Member, my goal is to conventional medical care. accept those health and wellness services that I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physiciansfeel will truly help me. I will receive such primary choose procedures that I consider proper and specialist care elsewherehave a reasonable chance of making my health and life better. I fully understand realize that no health screening, resulting conclusions or health care services are foolproof. For example, if I choose to forego drugs, surgery or treatments that have been recommended by others, in the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a memberpublic sector, I accept the goals of helping that risk. I assert my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects right of informed consent will take place in my discussions with the providers and my fellow members of the Associationconsent. My activities within the Association Academy are a private matter that and I refuse to share them with the any Federal or State Medical Boardregulatory enforcement agency, the medical board, FDA, FTC, Medicare, Medicaid Medicare or my own insurance company without my expressed specific permissionMedicaid. All The health and / or sickness records and documents that I have shared with other members remain as the property of the AssociationAcademy. I, even if I receive in becoming a copy of them. I fully member, agree not to file a malpractice lawsuit malpractice, civil or criminal lawsuits against a fellow member of the Associationmember, unless that member has exposed exposes me to a clear and present danger of substantive evil. I acknowledge further agree that all Academy members are exempt from the members provisions of the Association do not carry malpractice insuranceany state Medical Practices Act, Federal Food Safety Modernization Acts, Codex Alimentarius or any similar federal or state legislation. I enter into this the agreement of my own free will will, or on behalf of my dependent designated dependent, without any pressure or promise of curebenefits. I affirm that I do not represent any State state or Federal federal agency whose purpose is to regulate and approve productsthe practice of medicine or any other health care system. I accept that membership does not entitle me to any voting interest in the Academy. I acknowledge I am not liable for any debts, liabilities, suits or judgments against the Academy. I have read and understood understand this document, contract and my any questions have been I had were answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate This document consists of my membership in this association at any time. These pages and Article I of the articles of association of the Association consist of the entire agreement for my membership in the Association and they supersede it supersedes any previous agreementagreement I may have made. I understand that the my membership fee entitles me to receive those benefits declared by the Trustee(s) a Trustee to be “general benefits” , free of further charge. I also agree to pay pay, as levied levied, for those benefits that I request and receive that are declared by the Trustees to be “special assessments”, as per Fee Schedulea posted fee schedule. I also understand that all sales $10.00 of products and services are final, no exchange or refund. I enclose the sum of $49.95 as my initial consultation fee is for consideration for my one-time lifetime membership, but this fee has been waived by the Academy. The term of membership contract, said term beginning begins with the date of the signing and acceptance of this contract, agreement and by continuing until the dissolution of this Academy. By these presents I do hereby certify, attest attest, and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Contractual Application this application for Membership membership and I fully understand and agree with sameall of the provisions stated herein.
Appears in 1 contract
Samples: Private Partnership Agreement
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services products and careservices, do so in the capacity of a fellow member and not in the capacity as a licensed health care wholesaler, retailer or provider. I further understand that within the association no doctorwholesaler/retailer-patient customer relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, consumer/customer or client to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice recommendations and recommendations products offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosis, therapy, treatment products and care is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosis, therapy, treatment and care recommendations or products is my own free decision in an exercise of my rights and made by me for my the benefit, and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such carerecommendations and products, except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees Trustee and members have chosen Xx. Xxxx Xxxx Tai X. Xxxxxx as the person best qualified to perform services to members of the Association and entrust them to select other members to assist her them in carrying out that service. In addition, I understand that, since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of membership records maintained within the Association Association, which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare customer/consumer records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicableplans. I agree to join the Association, a private private-membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of lifeproducts. I understand that the doctors, nurses, and other providers who are fellow members of the Association are offering me adviceproducts, services, services and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or products on the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicaremarket. As a member, I accept the goals of helping my body function better and choosing techniques food products that are both very safe and have a reasonably good chance to succeedsafe, realizing that no diagnostic technique or treatment product testing is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical BoardBoard(s), the FDA, FTC, MedicareState Milk Board(s), Medicaid or my own insurance company USDA, Agricultural Board(s) and any other governmental agency without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice liability lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice liability insurance. The Trustee(s) shall have the right to sanction a member upon unanimous vote of the Trustee(s), after a hearing of the facts where the member may be present after notification. The sanctions include removal from active membership or imposing any other special and necessary conditions upon any member who shall discredit or bring harm to the Association in any manner. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cureproducts. I affirm that I do not represent any State or Federal agency whose purpose is to regulate and approve products. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time. These pages and Article I 1 of the articles of association of the Association consist of the entire agreement for my membership in the Association and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of $49.95 35.00 (non-refundable) as consideration for my one-time lifetime membership contract, “lifetime” meaning the lifetime of the membership association, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Xxxxxx’x Organic Farm Contractual Application for Membership Membership, and I fully understand and agree with same.
Appears in 1 contract
Samples: www.millersorganicfarm.com
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services education and care, care do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association no doctor-patient relationship exists but only a contract member-member- member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client patient to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosisprogram, therapy, treatment care and care products is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosis, therapy, treatment and care is my own free decision in an exercise of my rights and made by me for my benefit, benefit and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such care, etc., except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees Trustee and members have chosen Xx. Xxxxxxx Xxxx Xxxx Tai as the person one best qualified to perform services to members of the Association and entrust them him to select other members to assist her him in carrying out that service. In addition, I understand that, that since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff personsmember. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare records Records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicablemember. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, and other providers who are fellow members of the Association are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might are probably not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic evaluation technique or treatment remedy is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State officials, the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permissionpermission from the Association. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State state or Federal federal agency whose purpose is to regulate and approve productsthe practice of medicine. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association Association at any time. These pages and Article I of the articles Articles of association Association of the Association consist of the entire agreement for my membership in the Association Association, and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of $49.95 21.00 as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Health Balances Contractual Application for Membership Membership, and I fully understand and agree with same.
Appears in 1 contract
Samples: Health Balances
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services and care, do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association Association no doctor-patient relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosis, therapy, treatment and care is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosis, therapy, treatment and care is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such care, except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees and members have chosen Xx. Xxxx Xxxx Tai Xxxxxx X. Xxxxx and Xxxxxxxx X. Xxxxx as the person persons best qualified to perform services to members of the Association and entrust them him/her to select other members to assist her them in carrying out that service. In addition, I understand that, since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA HIPPA privacy rights and complaint process. Any medical or healthcare records kept by the association Association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicable. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, therapists, and other providers who are fellow members of the Association are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo forego drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State or Federal agency whose purpose is to regulate and approve products. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time. These pages and Article I of the articles of association of the Association consist of the entire agreement for my membership in the Association and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, ,” per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of $49.95 149.00 as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Xxxxx Health Happiness and Success institute’s Contractual Application for Membership and I fully understand and agree with same.
Appears in 1 contract
Samples: Membership Agreement
MEMORANDUM OF UNDERSTANDING. I understand that the fellow members of the Association that provide services products, education, nutritional counseling and care, care do so in the capacity of a fellow member and not in the capacity as a licensed health care provider. I further understand that within the association no doctor-patient relationship exists but only a contract member-member Association relationship. In addition, I have freely chosen to change my legal status as a public patient, customer or client patient to a private member of the Association. I further understand that it is entirely my own responsibility to consider the advice and recommendations offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and the acceptance of the offered or recommended diagnosistherapy and care, therapy, treatment and care etc. is my own carefully considered decision. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosistherapy and care, therapy, treatment and care etc. is my own free decision in an exercise of my rights and made by me for my benefit, and I agree to hold the Trustee(s), staff and other worker members and the Association harmless from any unintentional liability for the results of such care, etc., except for harm that results from instances of a clear and present danger of substantive evil as determined by the Association, as stated and defined by the United States Supreme Court. The Co-Trustees Trustee and members have chosen Xx. Xxxx Xxxx Tai Xxxxxxx Xxxxxx x’Xxxxxx as the person best qualified to perform health services to members of the Association and entrust them him to select other members to assist her them in carrying out that service. In addition, I understand that, that since the Association is protected by the First and Fourteenth Amendments to the U.S. Constitution, it is outside the jurisdiction and authority of Federal and State Agencies and Authorities concerning any and all complaints or grievances against the Association, any Trustee(s), members or other staff persons. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of medical and health membership records maintained within the Association which have been held to be inviolate by the U.S. Supreme Court, the undersigned member waives HIPAA privacy rights and complaint process. Any medical or healthcare Medical records kept by the association will be strictly protected and only released upon written request of the member. I agree that violation of any waivers in this membership contract will result in a no contest legal proceeding against me. In addition, the Association does not participate in any medical insurance plans or collections on behalf of the member member, but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicable. I agree to join the Association, a private membership association under common law, whose members seek to help each other achieve better health and live longer with good quality of life. I understand that the doctors, nurses, and other providers who are fellow members of the Association are offering me advice, services, and benefits that do not necessarily conform to conventional medical care. I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physicians. I will receive such primary and specialist care elsewhere. I fully understand that the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a member, I accept the goals of helping my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects of informed consent will take place in my discussions with the providers and my fellow members of the Association. My activities within the Association are a private matter that I refuse to share with the State Medical Board, the FDA, FTC, Medicare, Medicaid or my own insurance company without my expressed specific permission. All records and documents remain as property of the Association, even if I receive a copy of them. I fully agree not to file a malpractice lawsuit against a fellow member of the Association, unless that member has exposed me to a clear and present danger of substantive evil. I acknowledge that the members of the Association do not carry malpractice insurance. I enter into this agreement of my own free will or on behalf of my dependent without any pressure or promise of cure. I affirm that I do not represent any State state or Federal federal agency whose purpose is to regulate and approve productsthe practice of medicine. I have read and understood this document, and my questions have been answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate my membership in this association at any time. These pages and Article I of the articles Articles of association Association of the Association consist of the entire agreement for my membership in the Association Association, and they supersede any previous agreement. I understand that the membership fee entitles me to receive those benefits declared by the Trustee(s) to be “general benefits” free of further charge. I agree to pay as levied those benefits that I receive that are declared by the Trustees to be “special assessments”, per Fee Schedule. I also understand that all sales of products and services are final, no exchange or refund. I enclose the sum of Ten Dollars ($49.95 10.00) as consideration for my one-time lifetime membership contract, said term beginning with the date of the signing of this contract, and by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) ParaWellness Research PMA’s Contractual Application for Membership Membership, and I fully understand and agree with same.
Appears in 1 contract
Samples: parawellnessresearch.com
MEMORANDUM OF UNDERSTANDING. I understand that the fellow those members of the Association Academy that provide services and care, or advice do so in the capacity of fellow member-facilitators in a fellow member private manner and not in the capacity as a licensed health public health-care providerproviders. I further understand that within the association Academy no doctorPublic-patient Doctor-Patient or Public- Therapy-Client relationship exists but only a contract member-member Association relationshipexists. In additionWithin the Academy, I have freely chosen choose to change my legal status as from that of a public patientPub1ic Health-Care Recipient, customer or client to that of a private member of the AssociationPrivate Membership Academy care recipient. I further realize that in doing so I relinquish certain Federal and State protections and privileges. I understand that it is entirely my own personal responsibility to consider evaluate the advice and recommendations services offered to me by my fellow members and to educate myself as to the efficacy, risks, and desirability of same and or desirability. I agree that the acceptance of the offered or recommended diagnosisactions I take, therapyin this regard, treatment and care is are my own carefully considered decisionfree-will decisions. Any request by me to a fellow member to assist me or provide me with the aforementioned diagnosisIf I am accepted for membership, therapy, treatment and care is I will exercise my rights for my own free decision in an exercise of my rights benefit and made by me for my benefit, and I agree to hold harmless the Trustee(s), staff Academy and other worker members and the Association harmless member-facilitators from any unintentional liability for that might result from the results of such careadvice or services I receive, except for the harm that results could remotely result from instances an instance of “a clear and present danger of substantive evil evil” - as determined by the Association, Academy and as stated and defined by the United States Supreme Court. The Co-Trustees and members have chosen Xx. Xxxx Xxxx Tai as the person best qualified to perform services to members of the Association and entrust them to select other members to assist her in carrying out that service. In addition, I understand and accept that, since the Association Academy is protected by the First First, Ninth and Fourteenth Amendments to the U.S. United States Constitution, it is outside the jurisdiction and authority exempt from any action of Federal and State Agencies and Authorities concerning agencies entrusted to “protect the public” – as it relates to any and all complaints or grievances against the AssociationAcademy, any Trustee(s)its physical premises or equipment, members its Trustees, member-facilitators or other associated staff personsor consultants. All rights of complaints or grievances will be settled by an Association Committee and will be waived by the member for the benefit of the Association and its members. Because the privacy and security of membership records maintained non-judicial mediation, within the Association which have been held to be inviolate by the U.S. Supreme CourtAcademy. Also, the undersigned those membership and private member waives HIPAA privacy rights and complaint process. Any medical or healthcare records kept by the association will be Academy are strictly protected and can only be released upon written request of the subject member. I agree that violation of any waivers in I am joining this membership contract will result in a no contest legal proceeding against me. In addition, Private Membership Academy under the Association does not participate in any medical insurance plans or collections on behalf of the member but will provide a suitable invoice for the member to pursue reimbursement by his/her insurance company, if applicablecommon law. I agree to join the Association, a private membership association under common law, whose understand that members seek to help each other achieve and sustain better health and live longer with good quality of lifehealth. I understand accept that the doctors, nursesfacilitators, and other providers health-care providers, who are fellow members of the Association are offering me members, offer advice, services, and benefits that do are not necessarily conform conventional or traditional. As a Member, my goal is to conventional medical care. accept those health and wellness services that I do not expect these benefits to include on-call coverage, hospital care, or the usual and customary care provided by most physiciansfeel will truly help me. I will receive such primary choose procedures that I consider proper and specialist care elsewherehave a reasonable chance of making my health and life better. I fully understand realize that no health screening, resulting conclusions or health care services are foolproof. For example, if I choose to forego drugs, surgery or treatments that have been recommended by others, in the benefits I receive from the Association might or might not be covered by my health insurance and not at all by Medicare. As a memberpublic sector, I accept the goals of helping that risk. I assert my body function better and choosing techniques that are both very safe and have a reasonably good chance to succeed, realizing that no diagnostic technique or treatment is foolproof. If I choose to forgo drugs, surgery, or radiation that has been recommended to me by others, I fully accept the risk that I might suffer serious consequences from that choice. Other aspects right of informed consent will take place in my discussions with the providers and my fellow members of the Associationconsent. My activities within the Association Academy are a private matter that and I refuse to share them with the any Federal or State Medical Boardregulatory enforcement agency, the medical board, FDA, FTC, Medicare, Medicaid Medicare or my own insurance company without my expressed specific permissionMedicaid. All The health and/ or sickness records and documents that I have shared with other members remain as the property of the AssociationAcademy. I, even if I receive in becoming a copy of them. I fully member, agree not to file a malpractice lawsuit malpractice, civil or criminal lawsuits against a fellow member of the Associationmember, unless that member has exposed exposes me to a clear and present danger of substantive evil. I acknowledge further agree that all Academy members are exempt from the members provisions of the Association do not carry malpractice insuranceany state Medical Practices Act, Federal Food Safety Modernization Acts, Codex Alimentarius or any similar federal or state legislation. I enter into this agreement of my own free will will, or on behalf of my dependent a designated dependent, without any pressure or promise of curebenefit. I affirm that I do not represent any State state or Federal federal agency whose purpose is to regulate and approve productsthe practice of medicine or any other health care system. I accept that membership does not entitle me to any voting interest in the Academy. I acknowledge I am not liable for any debts, liabilities, suits or judgments against the Academy. I have read and understood understand this document, contract and my any questions have been I had were answered fully to my satisfaction. I understand that I can withdraw from this agreement and terminate This document consists of my membership in this association at any time. These pages and Article I of the articles of association of the Association consist of the entire agreement for my membership in the Association and they supersede it supersedes any previous agreementagreement I may have made. I understand that the my membership fee entitles me to receive those benefits declared by the Trustee(s) a Trustee to be “general benefits” , free of further charge. I also agree to pay pay, as levied levied, for those benefits that I request and receive that are declared by the Trustees to be “special assessments”, as per Fee Schedulea posted fee schedule. I also understand that all sales $10.00 of products and services are final, no exchange or refund. I enclose the sum of $49.95 as my initial consultation fee is for consideration for my one-time lifetime membership contractmembership, said term beginning with the date of the signing of but this contract, and fee has been waived by these presents do hereby certify, attest and warrant that I have carefully read the above and foregoing BRASIL AMERICAN ACADEMY OF AGING & REGENERATIVE MEDICINE (BARM) Contractual Application for Membership and I fully understand and agree with same.the
Appears in 1 contract
Samples: Membership Agreement