Terms of Service
Informed Consent/Authorization
The client terms of service and statement of responsibility stated herein establish terms under which Dr. G’s Clinical Hypnosis & Healing Services supplies access to telephonic, in-person and/or electronic consultation services and/or product purchases. You hereby agree to accept any and all responsibility for seeking these services and/or products through Dr. G’s Clinical Hypnosis & Healing Services and release the proprietor, his employees, affiliates, and any other agents from any responsibility for any and all perceived liability resulting from the use of Dr. G’s Clinical Hypnosis & Healing Services and/or any of the products and/or services contained therein.
In our effort to assure compliance with these Terms, Dr. G’s Clinical Hypnosis & Healing Services and its administrator(s) reserve the right, but not the obligation, to monitor any and all usage of the services and/or products provided through this website and any of its affiliate websites. Dr. G’s Clinical Hypnosis & Healing Services, in its sole discretion, may refuse access to the services/products offered due to actual or potential site misuse, noncompliance of terms and/or misuse of any and all services/products offered.
Prior to fulfillment of any service requests, users must verify that they have read and understand all of these stipulations, including the Statement of Client Responsibility.
Statement of Client Responsibility
In submitting my health information in connection with my request for services, the following statements are true:
Client Agreement & Acknowledgement:
As a customer or potential customer of the services provided by or through this website, I hereby understand, accept, and agree to the following:
In order to determine your compliance with these Terms, we reserve the right, but not the obligation, to monitor your access to and the use of the site and the Services offered herein. Dr. G’s Clinical Hypnosis & Healing Services may, in its sole discretion, refuse to provide access to the site or services due to actual or potential misuse of the site, these Services, or for noncompliance with these Terms. I realize that the consultant will not conduct an in-person physical examination and will rely on the truthfulness and accuracy of the information I am providing through any forms distributed to me.
I am using this platform because I am seeking meditation guidance from a professional.
I acknowledge that Dr. G’s Clinical Hypnosis & Healing Services, Dr. Robert Galarowicz, as well as any of his affiliates and/or employees do not practice medicine and are not healthcare service providers. I further acknowledge that Dr. G’s Clinical Hypnosis & Healing Services cannot and does not direct, control or influence the opinions or decisions made by the consultant or other assigned employee with respect to my care. I am voluntarily providing my health and medical information for the purposes of obtaining services through Dr. G’s Clinical Hypnosis & Healing Services
I agree that any dispute arising out of or related to the provision of services and/or products by Dr. G’s Clinical Hypnosis & Healing Services, by the consultant or other employee, or by their affiliates, employees, partners and agents, will be subject to mandatory mediation. Should mediation fail to resolve the dispute issue(s), said dispute shall be subject to final and binding arbitration and that all parties will agree to be bound by the arbitration, which will be enforceable in a court and that the parties waive any rights to bring suit in favor of agreeing to binding arbitration.
Any mediation, arbitration, administrative proceedings, or other proceedings shall be held in Bergen County, NJ, unless the parties agree otherwise, and shall be governed by the substantive law of the State of NJ without regard to conflicts of law.
I accept all risks, known and unknown, involved in, arising from or related to using the prescribed products or treatment. Subject to and without waiving any rights that may be conferred upon me under state or federal law, I will not seek indemnification and/or damages whatsoever of any kind from Dr. G’s Clinical Hypnosis & Healing Services for negligent, reckless or intentional acts or omissions, and I hereby hold harmless Dr. G’s Clinical Hypnosis & Healing Services from and against any and all liability relating to or arising out of my request for or receipt of treatment from Dr. G’s Clinical Hypnosis & Healing Services.
I hereby release Dr. G’s Clinical Hypnosis & Healing Services and the consultant and other employees from any and all claims that the consultant acted below the requisite standard of care on the basis that the consultant did not personally examine me.
I hereby acknowledge that all information and service provided by or through this web site and telephone service are provided “as is” without warranty of any kind, expressed or implied.
I acknowledge that any and all testimonials and/or reviews expressed by service provider represent only a cross section of the range of results that appear to be typical with these products and/or services. Results may vary depending upon client use and level of commitment.
If any provision of this agreement is held to be illegal, void or unenforceable, then this agreement may be modified or amended only to the extent necessary to enable the remaining provisions to be of force and effect to the maximum degree.
Client Authorization for Release of Individually Identifiable Health Information
In connection with providing certain individually identifiable health information to Dr. G’s Clinical Hypnosis & Healing Services, I authorize the following:
I hereby authorize Dr. G’s Clinical Hypnosis & Healing Services to use and disclose any of my health information, including all individually identifiable health information obtained through documents, forms and/or telephone consultations for the purpose of treatment, payment and health care operations. This authorization additionally includes, but is not limited to, any health information relating to HIV and other sexually transmitted diseases, mental health or disease, drug or alcohol treatments.
Dr. G’s Clinical Hypnosis & Healing Services and its privacy notice provides more detailed information about our privacy policies, and you are encouraged to review it before agreeing to this authorization.
I declare under penalty of perjury that the foregoing is true and correct. My agreement to this statement constitutes my signature.