Release form for frequency treatment

[Daniel Bergman]

I am starting to have people who would want me to try treat a condition of one kind or another, usually one that has not been resolved by conventional medicine.

I am looking to protect myself from any future problems related to treating people with frequencies as an experimental treatment.

Does anyone have a liability release form of some kind that covers this area?

Thank you.

Dan Bergman

[Marshall Stanton]

Dan'
Dr Johnson wrote some for himself and a few other doctors. There are copies to see.
Hopefully theirs is up to the technical application of the therapy.
It looked like it would cover most of what we do.
Than again?

Marshall

[Daniel Bergman]

Part of the problem is I am not a health care provider in any respect, so I have additional considerations that an MD would not.

I have been advised by a member of the forum that the only safe way to do this is to have people treat themselves. They would be using my equipment, and running it themselves. I can tell them what to do, but I should not touch or run the equipment.

Then, if the situation ever comes up where I am under some kind of scrutiny from authorities, I can honestly say "I never have treated anyone outside of my family". We are allowed to treat family members under current law. I only allowed unrelated people to use my equipment, but did not treat anyone.

I do think this would be the safest course to take, although somewhat awkward in practice.

Dan

[Alan Faulkner]

Does anyone have a release form that might be useful?

I've seen some online.

[Russell Shipp]

Everything I do , I do for gratuity.

I'll treat anyone willing to be treated.. although I never use the word treatment. Not till me and the client have been through a few sessions and gotten to know one another.


I don't use a release but if I did I should think that a good release form would look contractual.



I_______________________, Here by understand that I am being allowed to use ________________s' device under their supervision and that now medical claims are promised or implied. Use of their device is to be considered for entertainment purposes only.




Seems simple enough.... and should someone get cured and then get pissed off about being cured and call the authorities on you for Illegal healing... You can use my plan..... Should that happen to me I am gonna praise god and pass all the blame on him for providing the miracle.

:twisted:

[Richard Di Nucci]

Russell:

I am a newcomer to the Rife Forum, and I'm not a lawyer by trade. I commend you for starting this "release process", and hope that we can refine the wording soon, so that others on this Forum can use it whenever they feel the need to do so.

Since I know a fair amount about contract law, I've reviewed your draft "Release Form", as shown above (written in August 2012!), and I suggest a number of additions as well as clarifications.

Accordingly, here's my suggested re-write:
I, _________________________ fully acknowledge the implications of the following four (4) statements listed below; further, I fully understand, acknowledge, and accept the potential consequences of my actions either expressed or implied by the four statements below.

1. I have received a “Rife-type” of device, Model # _________________ (hereinafter referred to as “device”). I received this device from ________________________ on the date shown below.

2. I have been trained in the specific procedures that are to be used in connection with the safe operation of this entertainment device, and in specific safety precautions that are to be followed, before, during and after use of this device.

3. While in my possession, this device is to be used on an experimental basis by me only, and for the expressed experimental purpose of treating my own ailment(s), which I characterize as follows: ________________________________, __________________________, and _________________________________. (To All: Does this second portion of Statement # 3 sound OK to leave in, or should we delete any reference in this Release Form to "treatment of ailments"?)

4. Use of this device is for entertainment purposes only; however, I realize that in the process of using this device, I may experience some slight changes.
(Does that take care of any potential problem in Statement # 4?)



Signed: _________________________ and _______________________________
Temporary User of Device Owner of Device

Date: Date:

[Russell Shipp]

careful about consenting to admitting any kind of medical benefit. Otherwise it is a beautiful piece of leagliease.

But yeah, when people say Rife cures, they tend to end up doing time. Sometimes for right sometimes for wrong. .... IDK.. I'm about to reach for a larger market using sub par machines that are work horse ready. These mules may not be flashy but they are good mircals to be shared with as many as possible that will be willing to utilize them.

Thats my two cents.

I like your release much more.;

Save more that one part of part 4. ....... Lest anyone among us have to serve time for attempting to save a person.

[Richard Di Nucci]

Thanks Russell.

I'll try my best to incorporate your thoughts/ ideas in a revised version, which I hope to post back here on this link shortly.

R

EDIT: I've modified the draft Release Form" in the prior post; also shown in red are remaining questions for anyone who sees a potential issue or problem with the wording.

[Moria Merriweather]

I've signed so many releases like this, you'd think I would know what it should say!

Regarding the legal issues, I think there can be issues in any case, but I would note that it is much more complex if charge money for the use of the machine. Most of the issues I've heard of are when someone is selling something and makes claims for it. If you are. Not selling something (device or substance) and you want to give advice on treatment, you could still be liable in some cases, but it is more limited. In health books there are still disclaimers, but what you can say in a book is much broader than what you can say if you are treating someone for money.

[Russell Shipp]

Good reasons to never charge money for it! What is the price of life?

[Richard Di Nucci]

Thanks, Moria.

Although I implied that there was no compensation, we need to be explicit. I'll amend what I've written above, to clarify that the "caregiver" is receiving no compensation.

R
<img id="ums_img_tooltip" class="UMSRatingIcon">

[Richard Di Nucci]

Release Form for Rife Frequency Treatment – Revision 3


( note: recent additions/changes are shown in red)

I, _________________________ fully acknowledge the implications of the following six (6) paragraphs listed below; further, I fully understand, acknowledge, and accept the potential consequences either expressed or implied by these statements below.

1. I have received a “Rife" device, Model # ___________________ (hereinafter referred to as “device”) on temporary loan, for a maximum period of two weeks, from ________________________ on the date shown below. Further, while in my possession, I am responsible for the safe-keeping of this device.

2. I have been trained in the specific procedures that are to be used in connection with the safe operation of this device, and I have been trained in specific safety precautions that are to be followed, before, during and after the use of this device.

3. While in my possession, this device is to be used on an experimental basis by me only, and for the expressed purpose of treating my own ailment(s), which I characterize as follows: ________________________________, __________________________, and _________________________________. (To All: Does this second portion of Paragraph # 3 sound OK to leave in, or should we delete any reference in this Release Form to "treatment of ailments"?)

4. Use of this device is for experimental purposes only.

5. Though the maximum duration in my possession is specified in Paragraph # 1 as two (2) weeks, the device owner may request the return of this device after three (3) days, if necessary.

6. The device owner is receiving no compensation of any kind for allowing me to borrow this device.

Signed below by the Owner and the Temporary User of this Device:


_______________________________________
Temporary User of Device Date

_______________________________________
Owner of This Device Date


Question to Forum Members: Does anyone have additional suggestions/ changes? Or is there another “template” other than this draft above that will suffice?
<img id="ums_img_tooltip" class="UMSRatingIcon">

[Guichard Pierre]

The only solution to the people on the track and let RIFE
do some work alone. leave them assimilate technical RIFE first.
if they want to heal they work for themselves in a first time .

[Moria Merriweather]

Richard, I'm not a lawyer, but I think you need to change quite a bit.

Entertainment and experiment are 2 different things. Experimentally treating ailments is different from entertainment. Pick one wording or the other and stick to it.

Not sure what to cal the device but rife-like is not great.

I'm not sure what else.

[Russell Shipp]

Close. Let me touch it up .




Release Form for Rife Frequency Treatment – Revision 2



( note: recent additions/changes are shown in red)


I, _________________________ fully acknowledge the implications of the following six (6) paragraphs listed below; further, I fully understand, acknowledge, and accept the potential consequences either expressed or implied by these statements below.

1. I have received a “Rife-type” of device, Model # ___________________ (hereinafter referred to as “device”) on temporary loan, for a maximum period of _______ weeks, from ________________________ on the date ___________through _________. Further, while in my possession, I am responsible for the safe-keeping of this device.

2. I have been trained in the specific procedures that are to be used in connection with the safe operation of this device, and I have been trained in specific safety precautions that are to be followed, before, during and after the use of this device.

3. While in my possession, this device is to be used on an experimental basis by me only, and for the expressed experimental purpose of alleviating symptoms from and or causes of my own ailment(s), which I characterize as follows: ________________________________, __________________________, and _________________________________. (To All: Does this second portion of Paragraph # 3 sound OK to leave in, or should we delete any reference in this Release Form to "treatment of ailments"?)

4. Use of this device is for experimental purposes only; however, I realize that in the process of using this device, I may experience some possible physiological changes.

5. Though the maximum duration in my possession is specified in Paragraph # 1 as two (2) weeks, the device owner may request the return of this device after three (3) days.

6. The device owner is receiving no compensation of any kind for allowing me to borrow this device.

Signed below by the Owner and the Temporary User of this Device:


_______________________________________
Temporary User of Device Date

_______________________________________
Owner of This Device Date


Question to Forum Members: Does anyone have additional suggestions/ changes? Or is there another “template” other than this draft above that will suffice?
<img id="ums_img_tooltip" class="UMSRatingIcon">


5 and 6 could be whited out and or tweaked on this basis something could be loaned out and done up real nice..... Does anyone know if the carpenters grace has a release form they could share as a sample or template maybe? Compensation is an issue I leave up to anyone.. but yeah it is fine as it stands too in the quote.. I think that is a version I might start using Sans number 5 since two weeks is not the nomral amount of time it Takes for me tp heal up a sick person.... My clients tend to take 6 to 8 weeks to recover. Then again I tend to aim for the tougher ones...That is great up there... Who can improvwe upon it still further ;)

[Richard Di Nucci]

Russell:

Sure, I'm happy to hand it over to you, Russell, if you wish.

First, I need to explain my rationale as to why I inserted paragraphs 5 & 6, and maybe some other folks might want to comment as well, based on their experience.

Paragraph 5 Rationale:
In a court of law, a binding agreement should have a specified term that is expressed in writing. I don't have a Rife machine, so I don't have any experience loaning out a device. While I believe a 2 week term might be excessive, in contracts that involve no remuneration, the party involved in loaning out their equipment without cost has the right to take it back prior to the end of the period, and should stipulate a circumstance(s) wherein (s)he might require the equipment to be returned. Further, this paragraph lends further credibility to the fact that this is a contract without compensation.

Paragraph 6 Rationale:
Paragraph 6 is the crux of a "no compensation" type of contract agreement. Since there is no remuneration, it is clear to a court that the Rife device owner is performing an act of kindness, based on mutual signatures. Without this paragraph, the owner of the Rife device is not on solid ground, and a plaintiff's attorney could claim there was some implied benefit to the Rife device owner.
<img id="ums_img_tooltip" class="UMSRatingIcon">

[CharBoehm]

Use of the words "treating, treat, or treatment" might inhibit some from using this document. Any word that has an implication of a medical procedure could end up being problematic.

Best wishes,
Char

[Richard Di Nucci]

Thanks, Char. That was helpful.

I am not familiar with which terms and phrases are sensitive, and which phrases are "not to be used" at all.

R
<img id="ums_img_tooltip" class="UMSRatingIcon">

[Russell Shipp]

Use of the words "treating, treat, or treatment" might inhibit some from using this document. Any word that has an implication of a medical procedure could end up being problematic.

Best wishes,
Char


Yes indeed. The words of soul anguishing gut twisting. ..... Treatment. Never say treatment.

I always tell my clients that after we are all done, if they are all cured, we are gonna praise jesus and go to church. The feds we'll just leave out of it.

[Richard Di Nucci]

Release Form for Rife Frequency Treatment – Revision 5




I, ______________________________ fully acknowledge the implications of the following seven (7) paragraphs listed below; further, I fully understand, acknowledge, and accept the potential consequences either expressed or implied by these statements below.

1. I have received an experimental Rife device, Model # ______________________ (hereinafter referred to as “device”) on temporary loan, for a period of two weeks, from ____________________________(name of device owner) on the date shown below. Further, while in my possession, I am responsible for the safe-keeping of this device.

2. I have been trained in the specific procedures that are to be used in connection with the safe operation of this experimental device, and I have been trained in specific safety precautions that are to be followed, before, during and after the use of this device.

3. This device will be used by me only, and I agree that I will not allow other persons to use it while it is in my possession.

4. Use of this device is for education and entertainment purposes only.

5. The duration when this device is in my possession is specified in Paragraph # 1 as two (2) weeks; however, the device owner may grant me additional time to use this device. Further, there may be occasions when the device owner may require this device while it is in my possession. In that event, the device owner will provide a 24 hour "advanced notice" to me, that the device must be returned on the following day.

6. The device owner is receiving no compensation of any kind for allowing me to borrow this device.

7. The Temporary User of this device has been advised to seek the counsel of a licensed medical practitioner if they believe that they are ill.


Signed below by the Owner and the Temporary User of this Device:


_______________________________________
Temporary User of Device Date

_______________________________________
Owner of This Device Date


Comment to Forum Members: Feel free to use this template, or modify it in whatever way you wish; if there is another template that has been used and found to be acceptable by Rifers, please provide info about it, or a link to it within this thread.

[Arrow Durfee]

Yes, this last one is the one to use.

You are loaning the device and therefor have no culpability for what an individual may use it for.

you might consider adding that this device is not for the use of treating or curing any physical condition. All applications of frequency are experimental and unproven. This person has been advised to seek the counsel of a licensed medical practitioner.

[Richard Di Nucci]

Arrow:

Good points, all of them, and a welcome addition.

While I could add most of your additions, I believe I've covered the "on loan" topic and the "no culpability" topic sufficiently. Do you agree?

I believe your other major point ("not for treating or curing any physical condition") is worthy of consideration, and makes no inference for such use.

My Thoughts on Your Last Sentence:
("This person has been advised to seek the counsel of a licensed medical practitioner"). Looking at this sentence from the legal person's perspective, it draws too much attention to the inference that the person may, in fact, use it for medical reasons.

In regard to this "inference" stated above, I welcome your perspective, and perspectives from others as well.

Richard
<img id="ums_img_tooltip" class="UMSRatingIcon">

[Arrow Durfee]

Well trying to deny that this is going to be used for medical issues is another layer of denial. You know, your client or friend knows and so does the prosecutors and FDA as well as any judge.

Change the sentence to say. This person has been advised to seek the counsel of a licensed medical practitioner if they believe that they are ill.

It is a cover your butt sentence.

[Richard Di Nucci]

Arrow:

This afternoon, while doing some other work, I had time to reflect on these points, and ironically, I came to the same conclusion that you did!

I'll insert that sentence into the prior draft, and call it a new revision; that version should be sufficient as a starting point for someone who wants to draft a contract, and they can refine it further if they wish.

Tnks for your suggestions.

Richard
<img id="ums_img_tooltip" class="UMSRatingIcon">

[Max Reese]

thank you richard for your hard work

please don't get upset if i suggest one minor point.

in paragraph 5 instead of "after five [5] days" i would suggest instead

"by giving me 24 hours advance notice"

i only have one good machine and i might need it an emergency!

[Richard Di Nucci]

Max:

None of us should ever be offended if we ask post some idea, then ask for suggestions . . . whether we agree with them or not. In this case, your suggestion is actually a very good one, since most Rifers have only one Rife Machine, and are in the same predicament as you.

Free to Change Any Part of the Release Form Agreement:
I certainly will incorporate your comment, but please recognize that the draft "Template" above are just words, and all Rifers who see this Release Form and want to use it, are free to change it in whatever way they wish, in order to suit their individual needs.

So whenever you plan to use this form, please change, add to, or delete any portion of the wording in the associated paragraphs in whatever way you wish.

[Sergio Mason]

I just looked up musical rental agreement, I'd leave out anything to do with the use of the device, and just use one of the common rental agreements, I see nothing wrong in charging for the device. I've ordered a cheap one, but if it works out I'll get a more expensive one, and rent will help with the cost.

[Karl Buchanan]

Part of the problem is I am not a health care provider in any respect, so I have additional considerations that an MD would not.

I have been advised by a member of the forum that the only safe way to do this is to have people treat themselves. They would be using my equipment, and running it themselves. I can tell them what to do, but I should not touch or run the equipment.

Then, if the situation ever comes up where I am under some kind of scrutiny from authorities, I can honestly say "I never have treated anyone outside of my family". We are allowed to treat family members under current law. I only allowed unrelated people to use my equipment, but did not treat anyone.

I do think this would be the safest course to take, although somewhat awkward in practice.

Dan
The 1 thing I would add is

You are NOT telling them what to do. You are just sayi g what-you-would-do-for-your-own-self.

Ie, not "Run detox and healing after"
But "If it was me, I would run detox and then healing after?"

That subtle, all important difference

[David O´Mahony]

hi Dan , Your question was over a decade ago (I just joined the Ride forum in mid 2021), I guess you may well have treated quite a few people in that timespan. I am curious to know the outcomes before I spend money on a Rife product. Would you be able to share those outcomes here please? TIA. David

[Karl Buchanan]

"have been advised by a member of the forum that the only safe way to do this is to have people treat themselves. They would be using my equipment, and running it themselves. I can tell them what to do, but I should not touch or run the equipment."

I am a doctor and in the US its not even official "treatment", its spa and beauty realm? Non-invasive and yes? We do the patient involved just so we don't have to fool around with any fools or CREATE PAPERS TO USE AGAINST US when there is nothing to "justify" or create a paper for?

One thing i do not understand?
What is all the "my possession of the machine 2 weeks" and all that? I guess i do not see how it is relative in any way? If i shot a loon, where i rented the gun would not be the matter.

It just needs to say they have been informed and wsnt to try? You dont even need all that "as i exercise my right to" here, because its gone without saying.

More words equal more mess and it is really just simple? Don't feel like you have to over complicate it to sound qualified or "covered" because they just use it against you as "claims" and "posturing" anyway.

Go now and enjoy. Someday too soon the state medical board will want beauty shop girls to have a certificate. We will develop the SIMPLEST protective structure possible...not the most complicated.

[Karl Buchanan]

Yes, this last one is the one to use.

You are loaning the device and therefor have no culpability for what an individual may use it for.

you might consider adding that this device is not for the use of treating or curing any physical condition. All applications of frequency are experimental and unproven. This person has been advised to seek the counsel of a licensed medical practitioner.

You will tell the judge you advised them to see a dr but still rented them a unit?

[Daniel Bergman]

hi Dan , Your question was over a decade ago (I just joined the Ride forum in mid 2021), I guess you may well have treated quite a few people in that timespan. I am curious to know the outcomes before I spend money on a Rife product. Would you be able to share those outcomes here please? TIA. David

Hello David. I came to much the same conclusion that Karl did. If I let them use my machine then all the problems go away. I have not treated anyone who is not a relative. The one person that currently has one of my GB-4000 & MOPA was and maybe still treats himself for what started out as stage 4 prostate cancer. He is cancer free now but frequency treatments were one of many treatments he used. He did have chemotherapy but his condition was much better prior to that. He was quite diligent about his frequency treatments and herbal treatments.

The original post was before I became quite ill with Crohn's disease. I was still trying to get control of my wife's lyme disease and co-infections at the same time. I really had to focus on my own condition as it became life threatening in a relatively short time. Most of my time was spent on research and trial and error treatments to get control of my Crohn's. Without getting into the long story, I did figure out at least enough of the pathogens that caused my symptoms to get back to a normal life.

Once I discovered my wife had Bartonella along with her Lyme, things turned for the better. The Bartonella was difficult to get rid of partly because it ran for a long time before I knew it was there. However, eliminating the Bartonella made the Lyme much easier to deal with. I have found out recently that Lyme by itself is not nearly as difficult as Lyme with a co-infection. It puzzled me for a long time why the Lyme suddenly became easy to kill. Judy Mikovitz mentioned this in passing on a video about COVID 19. Finally had my answer. Smart lady.

To make a long story short, none of this could have been accomplished without a good frequency device. One of the pathogens involved with my Crohn's was Mycobacterium Avium subspecies paratuberculosis or (MAP) . There are no conventional treatments that can practically eliminate this pathogen. Dr. Borody in Australia has a antibiotic cocktail that takes years to hopefully get rid of it. No one else even tries.

I would not get a device to treat other people or as a source of income. I would get one because you have a problem that might be able to be resolved using a device. I don't rent my equipment. I primarily deal with family members and usually myself and my wife. Most people have no interest in it.

Best regards.

Dan

[Thomas Taylor]

That's interesting information Dan about your wife Bartonella. May I ask what was successful for you in treating that infection, that seems to be a really nasty one for a lot of people especially those who own cats.

[Daniel Bergman]

This thread is pretty much what I did. I think I later used a different Nutramedix product for Bartonella later on along with the frequency treatments but I don't recall which one.
432 was a good Bart frequency for us and for some reason 832 although it is not listed for Bart.

I got lax documenting this stuff toward the end. Possibly more is here somewhere but I am not sure. I have lots of Lyme treatment posts over many years.

https://www.rifeforum.com/forum/threads/3120-DNA-derived-frequency-treatment-for-Lyme/page16?highlight=Bartonella

Best regards.

Dan

[Thomas Taylor]

Thanks Dan I appreciate the response looks like on that forum message string you mentioned that frequencies weren't enough and you had to add cumanda and various herbs.

[Daniel Bergman]

It seemed to me that while a bigger share of the bart was eliminated by the initial frequency treatments, there was this stubborn remnant that remained.

I couldn’t get all of it and it seemed to reproduce quickly. Maybe if I would have ran frequencies overnight I could have done it. Never tried it.

The handicap in our case was my wife’s inability to tolerate oral treatments for very long. For the average sufferer this is not typically a problem. I think the combo treatment is a good way to get rid of it for good. Just treat longer than you think you have to. The same goes for Babesia. It is still there after the symptoms are gone.

Best regards.

Dan