Coach and Customer agree to keep confidential all nonpublic information provided to it by the other Party in connection with the performance of its obligations under this Agreement, except, if possible, as required by law, rule or regulation, pursuant to order of a court of competent jurisdiction, or the request of a regulatory authority having jurisdiction over, as appropriate, Coach or Customer, or as contemplated by the terms of this Agreement. Notwithstanding, anything to the contrary herein, each of Coach and Customer may disclose such nonpublic information to (i) its advisors, lawyers or representatives; provided that any nonpublic information designated by Coach or Customer as “Restricted Information” may not be shared with other parties without the prior written consent of the designating Party. Neither Coach nor Customer or its affiliates shall publicly announce or advertise Coach’s engagement without the prior written consent of the other Party.

Customer understands, acknowledges, and agrees that in connection with the Services, Coach may rely entirely upon information provided by Customer without independent verification of the accuracy and completeness of such information, as this will be provided in every session. If any information provided to Coach becomes inaccurate, incomplete or misleading in any material respect in regards of the purpose of the Services, during Coach’s performance of Services to which such information relates, Customer shall promptly so advice Coach.

At the same time, Customer understands, acknowledges, and agrees that the outcomes from the sessions, and for the Service itself, are not guaranteed and are contingent on completion of suggested daily practices provided by Coach to Customer. Failure to complete these practices will be the entire responsibility from Customer.

Coach and Customer (on behalf of itself and its affiliates) hereby represent and warrant as follows:

(i) Each has all right, power and authority necessary to enter into this Agreement, (ii) no licenses, permits or other authorizations, are required to be obtained by such Party from any domestic or foreign governmental or regulatory body in connection with the execution, delivery and performance of this Agreement by such Party, (iii) the execution and delivery of this Agreement by such Party and performance by such Party of the terms of this Agreement have been duly authorized by all necessary legal action, and (iv) each of the signatories hereof has the full power and authority to bind such Party hereto.

The operations of such Part at all times during the term of this Agreement will be conducted in compliance in all respects with all applicable laws, rules and regulations.

Customer understands, acknowledges, and agrees that the services here provided cannot, in any case, be considered a treatment of any kind, including and specifically referring to medical treatment. Customer understands that this is purely a Coaching service, requested by the Customer itself to Coach.

The Customer acknowledges that by the very nature of a phone or Skype consultation, the clinician providing the consultative services is unable to perform a physical exam on the patient.

Customer acknowledges that Coach has been retained as an independent contractor (and not in any fiduciary or agency capacity) to provide the Services hereunder. Customer acknowledges that Customer’s engagement of Coach is not exclusive and Coach may provide services to other parties. Nothing in this Agreement shall constitute or shall be deemed to constitute an employer-employee relation between the parties or constitute or be deemed to constitute either Party as the agent of the other Party for any purpose whatsoever. Neither Party shall have the authority or power to bind the other Party or to contract in the name of or create a liability against the other Party in any way and for any purpose.

Unless otherwise expressly agreed in writing by Coach, no one other than Customer is authorized to rely upon this engagement or any other statements or conduct of Coach, and no one other than Customer is intended to be a beneficiary of this Agreement.

Each party to this Agreement agrees to indemnify and to hold harmless the other party (each, an “Indemnified Party”), to the full extent allowed by law or equity, from and against any and all judgments, losses, claims (whether or not valid), damages, costs, fees, expenses or liabilities, joint or several, to which an Indemnified Party may become subject, related to or arising out of any breach by one party of its representations and warranties as set forth in the Agreement (a “Claim”). All amounts due to an Indemnified Party hereunder shall be payable by the party in breach of this Agreement promptly upon request and after provision of documentation reasonably sufficient to support the request by such Indemnified Party. In addition, the party in breach of this Agreement agrees to pay all costs and expenses (including attorneys’ fees) incurred by any Indemnified Party to enforce the terms of this Section 10. The provisions of this Section 10 shall remain in full force and effect regardless of any termination of this Agreement and shall be binding upon any successors or assigns of the parties.

Except as specifically otherwise set forth herein, this Agreement, and the rights and obligations hereunder, may not be assigned by either Party without the express written consent of the other Party.

This Agreement may be amended only by an agreement in writing signed by the parties. This Agreement contains the entire agreement between the parties with respect to the subject matter of the Agreement and supersedes all prior agreements and understandings, oral or written, between the parties with respect to the subject matter of the Agreement.

No failure or delay by any Party in exercising any right, power or privilege under this Agreement will operate as a waiver of the right, power or privilege. A single or partial exercise of any right, power or privilege will not preclude any other or further exercise of the right, power or privilege or the exercise of any other right, power or privilege.

This Agreement shall remain in full force and effect for a period of not less than two (2) years from the effective date indicated below provided, however, the obligations regarding confidentiality and non-disclosure set forth herein shall survive any termination or expiration of this Agreement and is concluded under the laws of the State of California, and said forum shall be the applicable law governing the construction, interpretation, execution, validity, enforceability, performance and such matters in respect to this agreement. In the event of dispute concerning any aspect of this or any transaction between the Parties, including breach or claim of breach thereof, the parties hereto agree to have the matter arbitrated under the American Arbitration Association rules of conciliation and arbitration then in force, and it will take place in San Francisco, California, USA. The results of such arbitration shall be final and binding on all parties hereto. The losing Party shall be responsible for reasonable cost and including attorney’s fees in these arbitration proceedings. Judgment upon this award may be entered in any court having competent jurisdiction thereof.

Justin Ehrlich, L.Ac. is a Licensed Acupuncturist. He does not claim to diagnose, treat, cure or prevent any medical conditions or pathologies, nor prescribe medicines. The services of a Licensed Acupuncturist do not replace those of a medical doctor. For any medical condition, you are advised to seek care from an appropriate licensed medical practitioner. Whether you choose to engage a medical doctor or not is your right and Justin Ehrlich, L.Ac. assumes no responsibility for your decision in this matter.

I, the Customer, assume any and all responsibility for decisions regarding my health, recognizing that (a) no claims are made that acupuncture, herbal medicines, nutritional supplements, dietary or exercise therapies can treat or cure any medical condition, (b) all recommendations are given for informational purposes only, (c) there is no implied or stated guarantee of success or effectiveness of any specific acupuncture, herbal medicine, nutritional supplement, dietary or exercise therapy recommendations, (d) I am free to act upon or disregard the recommendations of Justin Ehrlich, L.Ac. as I so choose.

I hereby request and consent to the performance of acupuncture treatments and other procedures within the scope of the practice of acupuncture on me (or the patient named above, for whom I am legally responsible).

I understand that methods of treatment may include, but are not limited to, acupuncture, moxibustion, far-infrared heat, cupping, gua sha, electrical stimulation, tui na (therapeutic massage), internal and topical herbal medicines, nutritional supplements, exercise therapies and nutritional counseling.

I have been informed that acupuncture is a safe method of treatment, but that it may have some side effects, including bruising, numbness or tingling near the needling sites that may last a few days, and dizziness and fainting. Bruising is a common side effect of cupping and gua sha. Unusual risks of acupuncture include nerve damage and organ puncture, including lung puncture. Infection is another possible risk, although the clinic uses sterile disposable needles and maintains a clean and safe environment. Burns and/or scarring are a potential risk of moxibustion and far-infrared heat. I understand that while this document describes the major risks of treatment, other side effects and risks may occur. The herbs and nutritional supplements (which are from plant, animal and mineral sources) that have been recommended are traditionally considered safe in the practice of Chinese Medicine, although some may be toxic in large doses. I understand that people can be allergic to almost any substance and will immediately stop taking any supplements or herbal prescriptions if I feel I have an allergic reaction and will contact Justin Ehrlich, L.Ac. I understand that some herbs may be inappropriate during pregnancy. I will notify the Justin Ehrlich, L.Ac. if I am or become pregnant. I will also immediately notify Justin Ehrlich, L.Ac. if there are any unpleasant effects associated with the consumption of the herbs.

Skype consultations are offered as a convenience for out of town patients seeking medical advice or life coaching. For new patients all paperwork must be completed, signed and returned to our office a minimum of one week prior to your appointment.

I understand that by the very nature of a phone or Skype consultation, that the clinician providing the consultative services is unable to perform a physical exam on the patient.

Physical exams can reveal important information about the patient and the patient’s condition. I understand that it is it is not possible to perform a physical exam during a phone or Skype consultation.

During my consultation, I understand that Justin Ehrlich, L.Ac. will evaluate my concerns based upon the information provided in my intake paperwork, our conversation and any included images. I understand that he will be providing me with general information about possible causes of my symptoms and potential treatment strategies and procedures. Possible treatment strategies can include acupuncture, Chinese herbal medicines, essential oils, nutritional supplements, dietary therapy, exercise, and meditation and qi gong.