Waiver and Release Form

MedMasters, LLC, and its affiliates, agents, employees, and owners (collectively, “MEDMASTERS, LLC”) believe that it is important to inform you of the inherent risks involved in the training offered by MedMasters, LLC. This Training Waiver and Release (“Waiver”) is between MedMasters, LLC, and the medical practice or individual trainee named below (referred to as “you” in this Waiver).

MedMasters. MedMasters, LLC training involves certain procedures being performed on a volunteer (the “Patient”). MEDMASTERS provides several different types of training, including the procedures below. MedMasters, LLC may add or remove activities, at its discretion.

  • Ozone Therapies
  • Ultraviolet Therapies
  • EBOO (Extracorporeal Blood Oxygenation and Ozonation) Therapies

The procedures in a MedMasters, LLC training involve removing blood from the patient, under sterile conditions, briefly exposing that blood to selected frequencies of Ultraviolet Light and ozone then re-infusing the blood back into the body. The blood may also be treated with a dosage of temporary acting anticoagulant (heparin or the like).

Risks Inherent in MedMasters. Participation in any MedMasters, LLC training where treatments are being administered to the Patient; may result in the following side effects:

  1. any side effects associated with but not limited to conventional venipuncture with IV angiocath or butterfly insertion such as bruising at the injection site and bleeding;
  2. any side effects associated but not limited to the conventional use of an anticoagulant such as heparin or the like as in bruising and bleeding;
  3. any side effects associated with but not limited to detox reactions including fever, muscle aches, joint aches;
  4. photo-allergies; and
  5. decrease in thrombolytic and coagulative levels in blood as noted in ozone literature.

By signing this Waiver, you represent and agree to the following, to the extent permitted by law:

Assumption of Risk. I voluntarily assume the risks associated with the MedMasters, LLC training and accept sole responsibility for my own health and safety and the health and safety of my staff, if signing on behalf of a medical practice. I am responsible for providing any personal protective equipment that I wish to use. I have authority to sign on behalf of myself, the organization that I represent, and my immediate family. I acknowledge having read and understood this Waiver and that I have had adequate time to ask any questions about this Waiver or the MedMasters, LLC training. I understand that no explanation or description of a treatment can ever fully explain every possible risk, side effect, or complication that could arise, but that by signing this Waiver, I willingly and knowingly assume the risk of engaging in a MedMasters, LLC training and administration of any ozone and/or ultraviolet light therapy.

Informed Consent from the Patient and Contraindications. I will obtain informed consent from each Patient that participates in the MedMasters, LLC training, if signing on behalf of a medical practice. MedMasters, LLC is not responsible to obtain informed consent from any Patient for any procedure that is part of a MedMasters, LLC training. I will review the list of contraindications for MedMasters, LLC training procedures and ensure that the MedMasters, LLC training is appropriate and safe for the Patient. If I am a Patient, then I give my informed consent to participate as a Patient in the MedMasters, LLC training.

Equipment. I will agree to provide at my own expense all necessary equipment and supplies required for any training sessions or educational activities as outlined in this agreement. I will agree to indemnify and hold harmless MedMasters, LLC from any claims, damages, or liabilities arising from the use or condition of the provided equipment during the training sessions. By using ozone and ultraviolet equipment as part of the MedMasters, LLC training you also confirm that you understand the medical literature and science behind both ozone and UBI therapies as it applies to the Patient. You also assume the risk of qualifying your patient to be a good candidate to receive such therapy.

Release of Liability, Indemnification, and Hold Harmless. On behalf of myself, my medical practice (if signing on behalf of a practice), and my immediate family, I release, agree to indemnify, and hold harmless MedMasters, LLC (and the MedMasters, LLC trainers) from any claim, liability, damages, expenses, or cause of action related to, arising from, or in any way connected to a MEDMASTERS Training. I further waive my right to sue for negligence.

Applicable Law. If any part of this Waiver is for any reason held to be unenforceable, the rest of it remains fully enforceable. Michigan law governs this Waiver, without regard to conflict of laws. Michigan law applies to this Agreement without regard for any choice-of-law rules that might direct the application of the laws of any other jurisdiction. This Waiver will be interpreted as broad and inclusive as permitted under applicable law. Unless the context requires otherwise, the term “including” means “including but not limited to.”

Signature

I have read this Training Waiver and Release, fully understand its terms, appreciate the potential impact of the type of injuries that could occur, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.