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TAMA Research Corp Client Profile and Waiver Liability Form

TAMA Research Corp Client Profile and Waiver Liability Form


Client Profile and Waiver of Liability Form

It is possible that you may suffer a physical injury, illness or adverse reaction as a result of undergoing the treatment and therapy offered by TAMA Research Corp. In the event that you have any adverse reaction to the administration of the treatment (or use of the device) administered in order to improve the tone and physical appearance of skin and supporting tissue, be sure to immediately see a physician for treatment or appropriate referral for treatment.

People with physical or mental limitations, have an implanted or other electrical stimulatory device, a history of seizures, epilepsy, or who are pregnant should not undergo the treatment and therapy offered by TAMA Research Corp.

The certified Aesthetician will provide you with a detailed, live explanation of the system and its proper use prior to use the system. The treatment and therapy offered by TAMA Research Corp. is not designed or intended to treat, cure, prevent or diagnose any disease, alignment or medical condition.

No claims offered in relation to the therapy have been evaluated by the FDA. This information is not to be substituted for advice from your physician or health care professional.

TAMA Research Corp. device:
When activated, the device will deliver a low current electrical stimulation, in combination with the application of a topical water, gel, or lotion, and produces varying levels of electrical stimulation, energy and intensity. Undergoing the therapy will affect the muscles, skin, and circulatory and nervous system. It may affect the functioning of any electrical devices used to treat a medical condition (e.g. pacemaker. See below related to these issue). Some people may find this therapy to be strenuous, uncomfortable, disorienting and/or stressful. Therefore it is recommended that you consult with a physician prior to undergoing therapy.

The live area of electrical stimulation activity is located at the tip of the device being applied to the surface of the skin.

Device Output/Energy Levels/Skin Response

The device applies an electrical stimulation measured between zero and 500 microamps.

Skin irritation or redness are possible, and may be associated with the use of an electronic muscle stimulator. A doctor should be consulted before using any electronic muscle stimulator, in case you have an underlying medical condition, which the electronic muscle stimulator could aggravate. Always seek doctor’s opinion before engaging in any new procedure.

Persons using medical devices such as pacemakers, implanted or other electronic nerve, muscle, or tissue stimulator, or hearing aids are not recommended to undergo therapy.

Medical and Waiver Form

Sensitive Medications or Skin Conditions

Certain medications, cosmetics or skin conditions may produce a greater sensitivity to the procedure. It is not recommended to undergo therapy if you have been diagnosed with a physical condition affecting the skin. As for medications or cosmetics, typically, these products feature a warning label to notify you of potential adverse effects. Please consult a physician prior to therapy if you are using any such products or medications or have a history of skin problems or believe yourself to be sensitive.

Waiver & Release Signature of Customer

I expressly acknowledge that my use of the therapy is undertaken at my sole risk. Any change in physical activity or routine are done so voluntarily with the complete understanding that I am responsible for all actions and assume all risks of injury, illness, disease or death.

TAMA Research Corp., or any agent thereof, is also not responsible for loss of any personal property.

This waiver and release of liability includes, without limitations, all injuries that may occur as a result of (a) use of equipment or products applied topically in conjunction with the equipment (b) the sudden and unforseen malfunction of the equipment (c) slipping or falling on the premises – including adjacent sidewalks, parking lots, etc.

I acknowledge that I have carefully read this waiver and product support materials and that I fully understand that this is a release of liability. I expressly agree to release and discharge the business, and all its affiliates, agents, employees, representatives, successors, or assigns, from any and all claims or causes of action and I voluntarily give up or waive any right that I may have to bring a legal action against the business for personal injury or property damage. To the extent that the statute or case law does not prohibit releases for negligence, this release is also for negligence on the part of the business, its employees and agents. If any portion of this release form from liability shall remain in full force and the offending provision(s) severed here from. This release supersedes all other signed release forms and shall be considered retroactive to the first date of the equipment usage. By signing this release I acknowledge that I understand its content and that this release cannot be modified orally.

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