Confidential Form

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.

If you are currently in the care of a professional psychotherapist or medical doctor, we require that you discuss your participation with them before participating in the program, in order to determine that the Brain Wave Training Program will not interfere with any work you are already doing with them.
*** If your medical doctor and/or your psychotherapist do not support your participation, or have not been given the opportunity to hear of and then to support your intention to take the Biocybernaut Institute Brain Wave Training, (if you answered "No" to any of the questions above: 13-C-i, 13-C-ii, 13-C-iii, or 13-C-iv), then we recommend that you DO NOT TAKE the brain wave training program at this time. Please call us immediately at (250) 391-1237 if you have any questions or if you do not have your psychotherapist's or your medical doctor's support.
*^* If you have answered "Yes" to any of the items in question 15.) above, please CONTACT US IMMEDIATELY TO DETERMINE THE APPROPRIATENESS OF YOUR PARTICIPATION IN THE TRAINING.
In the process of the training you may recall some past experiences which produced stress, anxiety, or sadness, as well as recalling experiences which were satisfying, joyful, romantic, and exhilarating. You may experience these emotions, and others as well, as you go through the training. If you are unwilling to experience such emotions, then we recommend that you not participate in the training program until you are ready and willing.

Please be aware your Biocybernaut experience may involve the reliving of many memories, including some childhood memories. Because of the nature of the development of the human consciousness, from childhood to adulthood, these childhood memories may be less than perfectly reliable.

In the process of the training you may be asked to look at, and to honestly evaluate, your own responsibility for events in your past and to forgive yourself and to forgive others for things that you or others did or failed to do. If you are unwilling to take some personal responsibility for your past experiences and if you are unwilling to do the forgiveness work of the training, then we recommend that you not participate in the training program until you are ready and willing.

In order to benefit from the training you must have your own clear intention to participate as fully as possible in the processes of the training. If you were pushed by someone else to do the training and/or you really do not want to do the training and/or if you are unwilling to participate as fully as you can in the processes of the training, then we recommend that you not participate in the training program until you, yourself, are ready and willing.

During the training time in your private feedback chamber you will need to sit upright and remain relatively still for extended periods of time. We do have available comfortable, well-padded arm chairs that can be adjusted up and down, and which swivel to maximize your comfort and good posture. We also have available adjustable foot rests to maximize your personal comfort and good posture. If you have any medical, physical, or psychological condition that makes it difficult or impossible to sit upright and to sit still in this helpful way,we recommend that you speak to one of the Biocybernaut Institute Trainers prior to participating in the Brain Wave Training Program.

More time is spent outside the feedback chambers than inside the chambers. After your time in the chamber you will be asked to describe your experiences in great detail for your Trainer, who will ask you many questions about your experiences in a through videotaped debriefing. Your Trainer will then provide you with helpful personalized coaching. You will be invited to recline on fluffy pillows on your own comfortable and cozy canopied single bed for these debriefings. The daily depth interviews are also conducted outside of the chambers. Also occurring outside the chambers are the very thorough data reviews and interpretations of your results, as well as meal times, and times for putting on the electrodes and watching videos and for asking questions. Most people choose to sit during these other activities outside of the feedback chambers, but sitting is NOT necessary if that would be uncomfortable for you. You may stand, kneel, or lie down for many of the other activities of the Alpha One Training. Much of the work that is done outside the chamber is amenable to reclining, and some people choose to go back and forth between sitting in comfortable chairs, lying on the floor on pads with pillows, lying in bean bag chairs, lying on canopied beds with blankets and pillows, and also kneeling and standing.

Drugs and medications can artificially affect your alertness and level of arousal, thereby making it harder to gain skill in brain wave feedback. Drugs and medications may also predispose you to certain potentially dangerous physiological reactions. We recommend that you DO NOT TAKE drugs, alcohol, or medications of any kind while participating in this program. However, DO NOT STOP taking any medications which have been prescribed by a physician, or drugs you are dependent upon for your health and well being. However, if you are taking any drugs or medications, please inform your Trainer so that we can determine how best to support your participation at this time. You are specifically requested not to use alcohol, nicotine, or caffeine either the day and night before, or at any time day or night during your training. Recall that caffeine is contained in some cold pills, some pain pills, in chocolate, in many teas (except herb teas), and even in many [partially] decaffeinated coffees. Heavy caffeine users may require 1-2 weeks of gradual withdrawal prior to their training, because caffeine addiction often causes headaches upon withdrawal. Caffeine is an addictive drug that causes anxiety and affects your level of arousal, making it harder to learn to control your own brain waves.
If you experience very severe pre-menstrual syndrome, we recommend that you consider not scheduling your training during that time. Levels of alpha EEG are lower during the pre-menstrual week, as is typical when anyone is under stress. We have found that the optimum levels of alpha, as well as optimum levels of learning of self-control of EEG, may not be achieved during the pre-menstrual week if you experience very severe pre- menstrual syndrome. If you have any questions, we recommend you speak with a Biocybernaut Institute Trainer.

Thank you for filling out this form. You will be asked to sign this form in doc format when you go in for your training.

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Deluxe Premium Double 7 day with Dr. Hardt

Premium Double trainings requested to be led by Dr. James V. Hardt, Founder and President of Biocybernaut, will be $79,998USD per person which will include the 7-Day Premium Double Training package.

Deluxe Premium 7 day Training with Dr. Hardt

Premium trainings requested to be led by Dr. James V. Hardt, Founder and President of Biocybernaut, will be $49,998USD per person which will include the 7-Day Premium Training package.

Premium Double 7 day Training

The 7-Day Premium Double training provides double the amount of Neurofeedback training time as the 7-Day Premium Training. The 7-Day Premium Alpha One Training has been scientifically proven to deliver significant beneficial results including continued improvement after the Training. The 7-Day Premium Double is an intense experience that enhances the experience of the Trainees and maximizes the results. In addition to providing double the Neurofeedback training time as the Premium 7-Day training, the Premium Double offers a gradual increase in the number of EEG head sites that the Trainee is given Neurofeedback. So the Premium Double gives double the amount of time in the feedback chamber and it works up to double the number of head sites at which the trainee is given feedback.

Premium 7 day Training

The Biocybernaut Premium is the 7-day training program that is the core Biocybernaut offering and with which all of our scientific papers have been produced. The 7-Day Alpha One Training is scientifically proven in peer-reviewed scientific publications, to deliver significant beneficial results to the Trainee, including the Trainee’s continued improvement after leaving the Training.

5 Day Intensive

This Training is based on the Premium Double 7-Day Training. It is for those people who cannot find the time to get away for the full 7-Day Training. The Trainee will experience neurofeedback training twice a day and will have an incremental increase on the head sites they will receive feedback.