We will hold the information on this form in strictest confidence. Please answer every question.
Before participating in the Biocybernaut Institute Brain Wave Training programs you must read the following information, and sign your name at the end of this form to indicate the accuracy and truthfulness of your answers to the questions herein and to indicate your agreement with, and your full and enthusiastic assent to, all the terms and conditions hereof.
The Biocybernaut Institute Brain Wave Training is an educational and research program in brain wave biofeedback designed by Dr. James V. Hardt, and utilizing a computer-based learning technology. Trainee acknowledges his/her understanding of the educational and research nature and purposes of this training, and Trainee acknowledges his/her understanding that the research procedures and protocols herein employed were developed by Dr. Hardt, reviewed and approved annually by the Committee on Human Research at the University of California, and were used for 12 years by Dr. Hardt (1976-1988) at UCSF during Dr. Hardt’s research work at the Langley Porter Neuropsychiatric Institute at the University of California at San Francisco, USA.
Trainee acknowledges that he/she wishes to participate in this training program of his or her own free will. There is no assurance of any beneficial or therapeutic result from this EEG research and education training, and careful records will be kept to determine if there is any beneficial outcome. Periodic two or three day follow-up trainings [called “Tune-Ups”] are recommended once or twice during the 6 months following completion of the Level 1 Training to assess and to help maintain the permanence of any beneficial results that may occur, but these “tune ups” are not required and they are not within the scope of this Training Agreement.
People often find that after the training they have a greater awareness, useful insights, an enhanced sense of well-being and that certain physical problems dissipate or actually disappear. However, we wish to be absolutely clear and to have your full understanding that the training is not a form of therapy or a practice of medicine. The training is not a substitute for the services of a professional therapist or a medical doctor. The Biocybernaut Institute Trainers who facilitate the training are not professional therapists or medical doctors. They are biofeedback practitioners and are certified by the Biofeedback Certification Institute of America and/or by Biocybernaut Institute, Inc. Please note that neither professional therapists nor medical doctors are in attendance at the Biocybernaut Institute Brain Wave Trainings.