PERMISSION & AUTHORIZATION FORM REGARDING THE USE OF NUTRITION RESPONSE TESTING

PLEASE READ BEFORE SIGNING:

I specifically authorize Gretchen Hahn to perform a Nutrition Response Testing Health Assessment and to develop a natural, complementary health improvement program for me which may include dietary guidelines, nutritional supplements, etc. in order to assist me in improving my health, and not for the treatment, or “cure” of any disease.

I understand that Nutrition Response Testing is a safe, non-invasive, natural method of assessing the body’s physical and nutritional needs, and that deficiencies or imbalances in these areas could cause or contribute to various health problems.

I understand that non-invasive, non-manipulative touch will be used to identify areas of weakness in the body.  If I am uncomfortable in any way during my visit, I have the right to question the procedures and to end the visit at any time.

I understand that Nutrition Response Testing is not a method for “diagnosing” nor “treating” any diseases including conditions of:  COVID, cancer, AIDS, Infections, or other medical conditions, and that these are not being tested for nor treated.

No promise or guarantee has been made regarding the results of Nutrition Response Testing or any natural health, nutrition or dietary program recommendations, but rather I understand that Nutrition Response Testing is a means by which the body can be used as an aid to determining possible nutritional imbalances, so that safe natural programs can be developed for the purpose of bringing about a more optimum state of health.

I have read and understand the foregoing.

This permission form applies to subsequent visits and consultations.