BY SIGNING THIS DOCUMENT I UNDERSTAND AND AGREE TO THE FOLLOWING:
Temna M McMillan-Sturdivant is a Natural Health Practitioner/Traditional Naturopath, providing remote or in-office Bio Energy Therapy that includes frequency resonance therapy, Reflexology, nutrition, herbal and supplement suggestions, consultations, coaching and for individuals or corporations. These services are not meant to and do not replace any Medical or Naturopathic doctor’s recommendations. I understand it’s my responsibility to consult with my doctor for any medical advice. I do hereby voluntarily consent to receive AO scans and services, Reflexology, massage, essential oils, herbs and supplements, wellness coaching and any other services or suggestions, today and henceforth.
Natural health practitioners/Traditional Naturopaths are NOT Medical Doctors (MDs). Natural Health Practitioners/Traditional Naturopaths are NOT Naturopathic Doctors (NDs). Natural Health Practitioners/Traditional Naturopaths are trained specialists who use non-invasive holistic practices to create a healthy environment for the mind, body and spirit.
I authorize Temna McMillan-Sturdivant and all Temna QLA, Inc. or Relax Rebuild professionals, practitioners and contractors to perform services and develop a natural, complementary health improvement program for me in order to assist me in improving my overall health and not for the treatment or “cure” of any disease.
I understand that the services rendered are safe, non-invasive, holistic methods of balancing the body’s physical, emotional, and nutritional needs and those imbalances can cause or contribute to various health problems. I am requesting services, suggestions and coaching from Temna McMillan-Sturdivant and any affiliate of Temna QLA or Relax Rebuild LLC. I perfectly understand Temna McMillan-Sturdivant, is not a doctor, nor does she claim to be one. She does not diagnose, does not prescribe medication, nor does she substitute any medical treatment. I am exerting my own free will and from the dictates of my own consciousness which allows me to choose what I believe is convenient for my persona and therefore I am interested in receiving the opinions, points of view and/or natural suggestions from this consultant which are suggestions with the objective of feeling better.
Temna McMillan-Sturdivant and all Temna QLA, inc. or Relax Rebuild LLC professionals, practitioners and contractors may discuss substances that have not been subject to double blind clinical studies or FDA approval or regulation. You assume the responsibility for the decision to take any natural remedy. If you feel you are having any adverse reaction, then stop taking all supplements immediately. This applies to all services as well. I understand this 30-Day RESET program and all related services such as frequency sound therapy, do not diagnose disease or illness.
This site, any website, social media, community group, and any other link affiliated with Temna QLA or Relax Rebuild LLC, is for informational and educational purposes only. Information is gathered and shared from reputable sources; however, Temna McMillan- Sturdivant and all Temna QLA or Relax Rebuild LLC, practitioners, professionals and contractors are not responsible for errors or omissions in reporting or explanation. The information contained herein does not constitute the rendering of healthcare advice or the provision of treatment or treatment recommendations. No individuals, including those under active care with Temna McMillan-Sturdivant and all Temna QLA or Relax Rebuild LLC, practitioners, professionals and contractors, should use the information, resources or tools contained within to self-diagnosis or self-treat any health-related condition.
I also make it clear that the contents and processes in and Temna QLA or Relax Rebuild program are for educational purposes only and are NOT to be used as diagnostic, prescription or medical treatment or replace such treatments. I am responsible to follow or not, any suggestions made. The products suggested, vitamins, minerals, herbs, homeopathic, supplements or any other natural, non-invasive suggestions are not prescriptions, and I dismiss the dispensary emails or texts using the word prescription. I understand that the dispensary suggestions DO NOT SIGNIFY A PRESCRIPTION OR MEDICAL TREATMENT. If you are under treatment, therapy or taking any medications prescribed by your doctor, DO NOT DISCONTINUE them!
Consult with your doctor BEFORE taking products or follow any suggestions. For emphasis: I understand that the contents and process in this program are for educational purposes only and are not to be used as diagnostic, prescription, or medical treatment. Only licensed doctors can diagnose, prescribe or give treatments. I am responsible to follow or not any suggestions. The products suggested are only for their nutritional value. The suggestions of these products do not signify a prescription or medical treatment. If I am under treatment, therapy or taking any medications prescribed by my doctor I DO NOT discontinue them. I need to consult my doctor BEFORE taking any products or following any suggestions.
I understand that I am completely responsible for any suggestions, procedures, and processes and relinquish the responsibility from the consultant, facility and any parties assisting during or after my appointment. In all cases it is my decision or our decision to whether or not take and/or follow or not the recommendations or services that have been suggested to me and will only be both mine and our responsibility to carry them out and the results of the same. I relinquish the consultant of any participation in legal matters, judgments, claims, liabilities and any other legal concepts not mentioned at any moment in time. Nothing said, done, typed, printed or reproduced by Temna McMillan-Sturdivant and Temna QLA, Inc. or Relax Rebuild LLC practitioners, professionals and contractors, is intended to diagnose, prescribe, treat or take the place of a licensed physician. I understand that Temna McMillan-Sturdivant and Temna QLA, Inc, or Relax Rebuild LLC practitioners, professionals and contractors not liable for my healthcare.
In consideration for receiving permission to participate in the services Temna McMillan-Sturdivant and Temna QLA, Inc.or Relax Rebuild LLC practitioners, professionals and contractors, I hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE Temna McMillan-Sturdivant and Temna QLA, Inc or Relax Rebuild LLC practitioners, professionals and contractors from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, while participating in such activity, while in, on or upon the premises where the activities are being conducted, REGARDLESS OF WHETHER SUCH LOSS IS CAUSED BY THE NEGLIGENCE OF THE RELEASEES, or otherwise and regardless of whether such liability arises in tort, contract, strict liability, or otherwise, to the fullest extent allowed by law.
I am fully aware of the risks and hazards connected with the activities of holistic treatments and practices and I am aware that such activities include the risk of injury, illness and even death, and I hereby elect to voluntarily participate in said activities, knowing that the activities may be hazardous to my body and my property. I understand that Temna McMillan-Sturdivant and Temna QLA, Inc. or Relax Rebuild, LLC practitioners, professionals and contractors does not require me to participate in these activities. I voluntarily assume full responsibility for any risks of loss, property damage, or personal injury, including death, that may be sustained by me, or any loss or damage to property owned by me, as a result of being engaged in such activities, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES or otherwise, to the fullest extent allowed by law. I further hereby agree to INDEMNIFY AND HOLD HARMLESS the RELEASEES from any loss, liability, damage, or costs, including court costs and attorney’s fees that may be incurred due to my participation in said activities, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES or otherwise, to the fullest extent allowed by law.
It is my express intent that this Waiver and Hold Harmless Agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assignees and personal representative(s), if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the above-named Releasees. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed in accordance with the laws of the State of North Carolina and that any mediation, suit, or other proceeding must be filed or entered into only in North Carolina and the Federal or State courts of North Carolina. Any portion of this document deemed unlawful or unenforceable is severable and shall be stricken without any effect on the enforceability of the remaining provisions.
In signing this document, I ACKNOWLEDGE AND REPRESENT THAT I HAVE READ AND UNDERSTAND THE FOREGOING WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT and that I am signing it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least Eighteen (18) years of age and fully competent; and I execute this Agreement for full, adequate and complete consideration fully intending to be bound by same.
If I am here accompanying a minor or a physically challenged person, I make it clear that as a father, mother, tutor, friend, relative, responsible party or caregiver I have the sufficient capacity and authority to allow receiving the recommendations for the minor or physically challenged person and agree the above waiver for them.
GROUP SETTING & RECORDED SESSIONS DISCLOSURE:
I understand that this wellness program is delivered in a group format, which includes live, interactive sessions conducted via video or audio-conferencing platforms. These sessions may be recorded for educational purposes and to support participant learning and engagement.
I acknowledge that, in the course of group discussion, I or other participants may voluntarily share personal health-related information. While no individual health records are ever shared outside the program and all facilitators agree to maintain the spirit of confidentiality, I understand that the group nature of this program means complete privacy cannot be guaranteed.
By participating, I agree to waive any rights or protections under the Health Insurance Portability and Accountability Act (HIPAA) related to group conversations and recorded sessions, and I accept full responsibility for any personal information I choose to share. I understand that my participation in these discussions is entirely voluntary and not required for access to the program.
CONFIDENTIALITY
Client agrees not to share any proprietary information, including:
Temna QLA, Inc. agrees to keep all personal health data, intake forms, and communications private and confidential.
MEDIA RELEASE AND OWNERSHIP CONSENT:
I understand that group sessions may be recorded and used for educational, training, or promotional purposes by Temna McMillan-Sturdivant and Temna QLA, Inc. I hereby grant full permission and irrevocable rights for my image, voice, likeness, and any comments voluntarily shared during recorded sessions to be captured and used in any format, including audio, video, written transcript, or digital media, without compensation or further approval.
I waive any right to inspect or approve the finished product and release Temna McMillan-Sturdivant, Temna QLA, Inc., Relax Rebuild LLC, and any affiliated agents from any claims or liability arising from such use. All recordings shall remain the sole property of Temna QLA, Inc.
INTELLECTUAL PROPERTY
All program materials, content, and delivery methods are the property of Temna QLA, Inc. and are protected by copyright law.
You may not share, sell, reproduce, repurpose, or distribute any part of the Program without written consent.
You are granted a single-user, non-transferable license for personal use only.
GOVERNING LAW
This Agreement is governed by the laws of the State of North Carolina, United States. Any disputes shall be resolved through binding arbitration in North Carolina.
CANCELLATION POLICY:
Due to the nature of this wellness program, including its preparation, scheduling, and limited participant capacity, all payments are non-refundable. By enrolling, you acknowledge that your space has been reserved and resources have been allocated in advance on your behalf.
To support your decision-making process, an initial non-refundable application fee is required. This application is reviewed for suitability, and upon approval, your remaining balance will be charged automatically. This structure ensures that each participant is fully committed before receiving program access. There will be no refunds, cancellations, or transfers once your payment has been processed.
SOLEX AO SCAN MOBILE CONSULTATION CONSENT AGREEMENT AND LIABILITY WAIVER.
I fully understand that Temna McMillan Sturdivant is an Independent Quantum Living Advocate or QLA.
In health & wellness,
Temna M Sturdivant
Dip.H.Ir., BCN, BNC, BCR, CNHP, LMT
Traditional Naturopath
Nutrition & BioEnergy Expert
Quantum Living Advocate
Founder, Temna Rebuild Programs
704.368.4447