I hereby understand and recognize that David McElroy is not an MD, Osteopath, Chiropractor, or Naturopath and that does not hold himself to the public as a representative of any said profession. I understand that the procedures desired are not related to the treatment of any underlying organic disorders in my body (if present), and that all procedures given to me are performed with the intent to balance body functions and nutrition and not intended to treat disease or symptoms as defined by the medical profession. I further acknowledge that David McElroy does not diagnose disease, prescribe drugs, or perform surgery. I understand that Myopractics is not regulated by the state or any state agency and that David McElroy is not governed by any licensing law and that he practices by the natural right of liberty. I hereby certify that I have read this entire form and that I understand and agree to the provisions described herein.