Dr. Anthony Cahill, "Dr T" works doing business as Humanengineering, Inc. He holds a degree in Clinical Hypnotherapy and Massage Therapy. I am aware that Dr. Cahill is a licensed Chiropractic Physician and that if he needs to use chiropractic techniques in order to assist my healing, I will be presented with an informed consent form that is associated with chiropractic treatment. I acknowledge that all information that I have given on the Client Intake Form (including my known medical conditions) is complete and accurate to the best of my knowledge. I also understand that therapeutic hypnosis, massage, guided imagery, relaxation and energy healing techniques are not substitutes for medical or psychological diagnosis and/or treatment. I understand that Humanengineering, Inc. does not diagnose conditions or prescribe drugs, nor do they interfere with the treatment provided by a licensed medical professional. It is my responsibility to seek the care of a licensed healthcare professional for any physical or psychological ailment that I may have. I also understand the nature of Humanengineering, Inc.’s services and freely elect to receive those services.

I understand that if I am a minor (under the age of 18,) the consent of a parent or guardian is required and they must attend treatment sessions.

Therefore, except in the case of gross negligence, I or my representative(s) agree to fully release and hold harmless Humanengineering, Inc. from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s).

I give my consent and understand that what I am seeking treatment for may be shared during the group sessions as I am being worked on. I agree to keep confidential any and all information that is shared about others during the group sessions. Furthermore, if I do not want any information released about my condition, I will notify Humanengineering, Inc. prior to the first session.