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Private License, Informed Consent and Release

Print Name:

The undersigned hereby grants a Private License to Debbie Brookham C.P.N. to engage in nutritional and holistic health modalities with the undersigned's pet.

The undersigned acknowledges that the Practitioner is not a veterinarian and does not diagnose or prescribe for medical or psychological conditions, nor claim to prevent, mitigate, or cure such conditions. The Practitioner does not provide diagnosis, care, treatment or rehabilitation of animals, nor does the Practitioner apply medical, mental health or behavioral development principles.

The Practitioner helps pets achieve and/or maintain good health and peak performance by nutrition and holistic health means, without the use of drug material remedy or other medical means. The undersigned gives Informed Consent to the services that will be provided.

The undersigned hereby releases the Practitioner and Pet's Healthy Choice from all claims and liabilities arising from the use or misuse of diet plans, nutritional supplements or other holistic health modalities, indemnifying and holding the practitioner harmless from all claims and liabilities there from, whatsoever. The Practitioner reserves all rights.


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