Thank you for your interest in working with Anthony William, Inc. dba Anthony William, Medical Medium (“Anthony William, Medical Medium”). Using several holistic modalities, Anthony William, Medical Medium seeks to identify the source of imbalances in the body, and provide you with coaching and guidance for self-healing. Anthony William, Medical Medium is not a licensed medical doctor, chiropractor, osteopathic physician, naturopathic doctor, nutritionist, pharmacist, psychologist, psychotherapist, or other formally licensed healthcare professional. Therefore, Anthony William, Medical Medium does not render medical, psychological, or other professional advice or treatment, nor does it provide or prescribe any medical diagnosis, treatment, medication, or remedy.
As a client of Anthony William, Medical Medium, you must take complete responsibility for your physical health and emotional wellbeing.
The techniques used by Anthony William, Medical Medium are not intended to diagnose, prescribe, treat, or cure any condition or disease, whether physical, emotional, or mental. These techniques may be used in conjunction with any existing healthcare system, whether traditional or alternative, but are not intended to be a substitute for professional medical advice and competent, regular and appropriate medical care, medical treatment or mental health therapy. You are not advised to discontinue or to avoid medical or psychological consultations and Anthony William, Medical Medium encourages you to seek the care of a licensed healthcare professional if you believe such care is required.
You should not discontinue or modify any current medication or treatment without first obtaining approval from a licensed healthcare professional. If you believe anything related to our services or any related products causes you an undesirable reaction or what could be termed a side-effect, immediately consult with a licensed healthcare professional and cease use of whatever it is you believe may be causing this issue.
Any information or guidance provided by Anthony William, Medical Medium should not be construed as a prescription, a promise of benefits, a claim of cures, or a guarantee of results to be achieved. Anthony William, Medical Medium makes no guarantees or warranties related to its services. You agree to disclose to Anthony William, Medical Medium, any and all information that may affect the services that it provides and any products related thereto, and to furnish Anthony William, Medical Medium with truthful, accurate and complete information.
You agree to take complete responsibility for your physical health and emotional wellbeing and to promptly contact a professional healthcare provider in the event that you believe that you have a medical condition that warrants professional care.
You, on your own behalf and on behalf of your heirs, personal representatives, guardians and any persons deriving their claims through you or on your behalf, hereby waive, release and hold harmless Anthony William, Medical Medium and its officers, directors, employees, independent contractors, agents and stockholders (the “Released Parties”) from any and all claims, liabilities and damages of any nature or kind whatsoever, related in any way to the products or services provided by or through Anthony William, Medical Medium.
You also acknowledge and agree that the Released Parties are not responsible for the negligent or intentional acts or omissions of any third party or for any of your own actions or inactions, that the total liability of the Released Parties shall be limited to the total purchase price of any products or services purchased by you from Anthony William, Medical Medium and that the Released Parties will not be liable for any direct, indirect, special, incidental, consequential, or punitive damages.
If there is any dispute involving this Agreement, the payment of fees, the products or services provided by or through Anthony William, Medical Medium, or any other matter (the “Dispute”), you agree to first try to resolve the Dispute through direct negotiation with Anthony William, Medical Medium. If the Dispute is not settled through direct negotiation, you agree to try in good faith to settle the Dispute by mediation before resorting to arbitration, litigation, or some other dispute resolution procedure.
You agree to indemnify, hold harmless and defend, the Released Parties from and against, any and all claims, liabilities, damages and expenses of every kind or nature whatsoever arising out of or attributed, directly or indirectly, to your failure to disclose truthful, accurate and complete information relevant to the services provided by Anthony William, Medical Medium and any products related thereto.
You hereby irrevocably (i) submit to the jurisdiction of the courts of the State of Florida and the United States District Court for the Middle District of Florida, Tampa Division, for the purpose of any suit, action or other legal proceeding arising out of or in connection with this New Client Agreement and Intake Form (the “Agreement”), the services provided hereunder, or the relationship between you and Anthony William, Medical Medium created hereby (each a “Proceeding”); (ii) waive, to the fullest extent permitted by law, any objection, constitutional, statutory or otherwise, to the jurisdiction of any such court or from any legal process therein; (iii) agree not to commence any Proceeding other than in the State of Florida; and (iv) waive, to the fullest extent permitted by law, any claim that such Proceeding is brought in an inconvenient forum. By entering into this Agreement, you understand that you may be called upon to answer a claim asserted in the State of Florida.
This Agreement contains the entire agreement between you and Anthony William, Medical Medium and supersedes all prior agreements and understandings, oral or written, with respect to the subject matter hereof. If any term or condition of this Agreement shall be invalid or unenforceable to any extent or in any application, then the remainder of this Agreement, and such term or condition, except to such extent or in such application, shall not be affected thereby and each and every term and condition of this Agreement shall be valid and enforceable to the fullest extent and in the broadest application permitted by law.
By checking the box below, you acknowledge that you have read, understand and agree to the terms and conditions above and voluntarily consent to participate in coaching sessions with Anthony William, Medical Medium and to immediately pay the scheduled rate for such sessions.