Consent, Disclaimer and Disclosure
I request that Brian Brezinski perform a nutritional evaluation and set up a diet, supplement, detoxification and lifestyle program for the purpose of enhancing health and improving well-being. I understand that all testing, techniques and supplements are recommended/provided for the purpose of reducing stress and balancing body chemistry and that Brian Brezinski is providing these services as an unlicensed nutrition consultant. None of the services/products recommended or provided are intended as diagnosis, treatment or prescription for any mental or physical disease, and are not intended as substitute for regular medical care.
I authorize the sharing of my personal information, analysis and/or other testing results with Dr. Lawrence Wilson, and/or other health practitioner within the Nutritional Balancing Academy that Brian Brezinski may consult for the purpose of designing my nutritional program.