1) I, the undersigned, hereby request consultations with Mati H Fuller, DI Hom(pract) regarding the use of homeopathic remedies for the purpose of improving my health and well-being. I declare that I have sought advice on my own and am fully responsible for my own body and my own life.

2) I understand that it is my right to decide how I will care for my health, so if I so choose, I retain the right to take the homeopathic remedies that may be indicated for my condition, even though I understand that there is no guarantee of a cure and no guarantee that my symptoms will lessen or improve. I will not hold Mati H Fuller responsible for a worsening of my current symptoms or any new ones that may arise.

3) I understand that the State of Colorado doesn’t issue licenses for alternative practitioners, and that this consultation is only meant as an educational or informational service. I understand that if a remedy is indicated for the purpose of enhancing my health or quality of life, it is totally up to me whether I choose to buy or use this remedy. I also understand that this consultation does not involve any kind of diagnosis, prescription or treatment of any specific disease.

4) I understand that Mati H Fuller is a DI Hom (pract) with diplomas in basic and practical homeopathy from the British Institute of Homeopathy in London. She has done clinical training with Karen Allen, CCH, RSHom(NA), RC, and is currently studying postgraduate homeopathy with Dr. S.K. Banerjea at Bengal Allen College of Homeopathy in Chelmsford, England. She is also the author of the book "Beyond the Veil of Delusions, Understanding Relationships Through Homeopathy."

5) I understand that Mati H Fuller is not a medical doctor, and that homeopathic consultations are not intended as a substitute for regular medical care. I realize that I should consult with my medical doctor if there is a need or desire for medical evaluation, diagnosis or treatment. I also understand that the use or discontinuation of prescription medicines has to be decided and monitored by a medical doctor, and if I choose not to follow the advice made by my medical doctor, I am solely responsible for the consequences of such a decision.

6) I understand that, occasionally, Mati H Fuller may offer homeopathic core analysis as part of a homeopathic consultation for the purpose of helping me understand how mental or emotional issues can affect my health, and that it is up to me to decide whether or not I want this service. I also understand that homeopathic core analysis is not a necessary part of a homeopathic consultation, nor is it intended as a substitute for psychotherapy, and that I should consult with a clinical psychologist if there is a need, or desire, for psychological evaluation, diagnosis or treatment.

7) I understand that Mati H Fuller has the right to terminate our relationship if she feels that she can’t help my condition, for whatever reason, and I shall not hold her liable for any damages whatsoever, including (but not limited to) loss of wages, revenues or business, or disappointed expectations of any kind. I agree that if I am not happy with the service provided, the only solution shall be that I stop using the service.

8) I also declare that I am here on this and any subsequent educational consultations including in person, over the phone, or via email, solely on my own behalf and not as an agent for any federal, state or local government agencies, or any other group or organization, on a mission of investigation or pursuit of entrapment.

9) I claim my rights to see an alternative practitioner of my choice,
according to the 9th amendment of the constitution:
ARTICLE IX, U.S. CONSTITUTION
"The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the People".

Under the Ninth Amendment to the Constitution of The United States of America, I retain the right to freedom of choice in health care. This includes the right to consult with a homeopathic practitioner, and to obtain, purchase and use any remedy or product as indicated for my condition.

The enumeration in this declaration of these rights shall not be construed to deny or disparage other rights retained by me, or my right to amend this declaration at any time.

CONSTRUCTIVE NOTICE
Notice is hereby given to any person who receives a copy of this Declaration and who, acting under the color of law, intentionally interferes with the free exercise of the rights retained by me under the Ninth Amendment, as enumerated in this declaration, that they may be in violation of my civil and constitutional rights, Title 42, U.S.C. 1983 et seq. and Title 18, Section 241.

I agree

I decline

_________________________________________________________________

Email Mati at: matifuller@hotmail.com
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