I request that I be allowed to participate in Dr. Lori Puskar’s “Online Nutrition Program”, a program which allows Dr. Lori Puskar to supply general nutrition not related to nor for the handling of any health symptoms, conditions, diagnosis, and/or to treat or cure any illness or disease; and for me to purchase supplements online and be in control of my own nutrition and supplements.
I understand that no guarantee is made in this program regarding my nutrition or health including any recommendation, statement, article, employee, educational media/material from Dr. Lori Puskar. I will not hold, Lori Puskar, DC, her LLC, or any of its direct or indirect; associates, affiliates, representatives and/or vendors, liable for any situation regarding my body, health, nutrition or any purchase from Dr. Lori Puskar.
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I have read and understand the foregoing and agree that by filling out and electronically signing the form below, this gives my consent and applies to all previous paragraphs and any/all previous and future interactions with Dr. Lori Puskar of any kind.
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