Acceptance into the Training in no way implies that I may lawfully use or employ the microscope or the techniques taught in this Training in my practice or in the practice where I am employed. I hereby acknowledge and agree that it is my personal responsibility to determine the nature of and comply with all federal, state, professional or license requirements relating to my area of practice as such requirements relate to the use of the microscope in my state or province. It is mutually understood that this agreement is not intended as a restraint of free trade, but is freely entered into with full knowledge of the restrictions and obligations set forth herein. I have read the information contained herein, and II understand and agree with all of the above. This form must be returned with fees and registration forms for each participant.
Registration is comeplete when a paperwork and fees are received and approved.
759-1255 Sign the Statement of Agreement and Understanding and send it along with a copy of your Health Practitioners License. If you are not licensed yourself, you must send in a letter from a Licensed Health Practitioner stating that you are working under their direct supervision and that they are legally responsible for you. Include a copy of their license with the letter.