Release form for frequency treatment

[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?
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[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?
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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.
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[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
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[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.