Healing Pathway Disclosure and Disclaimer
You may review, print and sign this disclaimer before a Healing Pathway event or service. Please keep one copy for yourself and return the other to us. We will retain it for a period of three years.
CALIFORNIA SENATE BILL SB-577 – WHAT IT MEANS FOR PATIENTS
California Senate Bill SB-577, which was signed by the governor in September 2002, has profound
implications for the practice of alternative forms of health care in California. SB-577 enables alternative and
complementary health care practitioners to provide and advertise their services legally. However, they must
also comply with certain requirements specified within the bill.What does Senate Bill SB-577 mean for you,
the patient? SB-577 gives you access to alternative and complementary health care practitioners. You must be
given information about the nature of treatment and the practitioner’s qualifications. Feel free to ask a
practitioner any question you might have about your treatment. Check to see if your practitioner has been
certified by a professional membership society. In addition, tell your doctor about any alternative treatment
you are pursuing. You can also request that your licensed and unlicensed health care providers communicate
with each other and work collaboratively to meet your health care needs. SB-577 helps to protect you. SB-577
requires unlicensed alternative health care practitioners to follow certain guidelines and restrictions.
Here are the things that unlicensed alternative practitioners are NOT allowed to do:
· Perform any form of surgery or any procedure that punctures your skin or harmfully invades your body.
· Use X-ray radiation.
· Prescribe prescription drugs, or recommending that you discontinue drugs that were prescribed by a
licensed physician.
· Set fractures.
· Treat wounds with electrotherapy.
· Put you at risk of great bodily harm, serious physical or mental illness, or death.
· Imply in any way that they are licensed physicians.
In addition, an unlicensed alternative practitioner MUST DO the following things:
· Provide you with a statement, written in plain language that includes the following information: (1) that
they are not a licensed physician and that their services are not licensed by the state; (2) a brief and clear
description of the kind of services they provide and the reasoning behind it; and (3) a description of their
education, training, and experience.
· Ask you to sign an acknowledgement that you received the above written statement, and provide you with a
copy of it. They must also keep a copy of your signed acknowledgement for three years.
For more information visit: http://www.californiahealthfreedom.com
Healing Pathway Disclaimer and Release of Liability:
Dr. Terri Shannon-Renfro, ND (unlicensed), DNM has been awarded two doctoral degrees from Trinity School of Natural Health and is certified to practice and teach Cellular Response, an energetic bodywork therapy. She has obtained a Doctor of Naturopathy (ND-unlicensed) degree and a Doctor of Naturopathic Ministry (DNM) degree. She is not a physician or medical doctor or a medical professional of any kind. Dr. Shannon-Renfro and Healing Pathway offer bodywork and massage services as well as coaching and mentoring to assist clients in relaxation, stress relief, integration of mind/body and spirit, and wellness training, including diet and lifestyle coaching, the use of essential oils or Traditional Flower Remedies to enhance well-being. This includes various forms of alternative healing practices which are not licensed by the state of California but are allowed under conditions specified in the legal code.
Dr. Terri Shannon-Renfro and Healing Pathway do not diagnose, prescribe medications, treat or cure any disease or disorder or offer medical advice in any way. You are offered information based in research and observation not intended to be medical advice or treatment. Services rendered are not to cure or treat any disease or disorder from a medical perspective in any way. We operate under the provisions of California State Law based on SB577. Text of this law is available upon request.
The purpose of our services is to educate and assist you in meeting goals you set for yourself (coaching), offer you wellness information (education) or provide comfort through bodywork/relaxation and other techniques of this type. We make no attempt to create any medical doctor-patient relationship or contradict/override any medical consultation, treatment, diagnosis or examination provided by a medical professional.
We urge you to always seek the advice of a trained medical professional with any questions you may have regarding a medical condition and before seeking any treatment. We advise notifying your doctor regarding this or any other diet and exercise plan you decide to follow.
Proper medical attention should always be sought for specific ailments. Never disregard professional medical advice or delay in seeking medical treatment due to information obtained from Dr. Shannon-Renfro or Healing Pathway. Any information presented is not intended to diagnose, treat, or cure.
In the process of coaching sessions you may be presented with excerpts from various books, publications or websites that may or may not contain information you find helpful or beneficial. These are presented for information and discussion purposes only. Some of these materials may express opinions or represent facts that have been untested and may not reflect the opinions or beliefs of Healing Pathway and Dr. Shannon-Renfro. You are under no obligation to follow any advice presented by Healing Pathway or Dr. Shannon-Renfro or that presented in the materials or websites, blogs, etc.
Legal Disclaimer Overview-
Healing Pathway and Dr. Terri Shannon-Renfro and the materials/ideas presented do not constitute an attempt to practice medicine but are for informational purposes only. • The use of the Healing Pathway materials, services or website do not establish a doctor-patient relationship • Individuals should consult a qualified health care provider for medical advice and answers to personal health questions •
I have read and understand that Dr. Terri Shannon-Renfro ND (unlicensed), DNM and Healing Pathway are not medical professionals and do not diagnose, treat, prescribe for or cure any diseases or disorders. I understand they are not a substitute for medical care or advice to be obtained from a medical professional. They will not advise me to disregard the advice of any medical health professional. I understand that it is important to inform Dr. Shannon-Renfro of my medical history, medications, conditions, etc. and seek a doctor for any medical concerns I may have or symptoms I may experience.
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I understand I must cancel or reschedule with 24 hours notice or I will be charged for the missed session. If I am late for a session, I understand this will not result in an extended session.
Terms-To be paid in full at the start of orientation/coaching series/or individual session Payable by Cash/MC/VISA/AMEX (via Square)
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I understand that diet and nutrition affect my health and wellbeing and I take full responsibility for my health. I have disclosed any medical information that might affect my coaching or dieting experience and I will not hold Dr. Terri Shannon-Renfro or Healing Pathway liable or responsible in any way but will seek the advice of a qualified health professional.
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Signed:_______________________________________
Print Name:____________________________________
Date:_______________________