Pre Evaluation

CHECKING “I AGREE” AND CLICKING THE “SUBMIT” BUTTON – OR USING OUR SITE – MEANS THAT YOU AGREE TO OUR ENTIRE TERMS & CONDITIONS. PLEASE REVIEW OUR PRIVACY STATEMENT.
If you think you or someone you are taking care of has a medical or psychiatric emergency, call 911 or go to the nearest hospital. Do not delay seeking treatment or medical advice because of something you have read on this website. Our site provides health information and access to our services. It is not a substitute for professional medical advice.
Occasionally, we may make changes to the Terms and Conditions. It is your responsibility to read the site Terms and Conditions from time to time. Your continued use of the site will indicate your agreement to the revised Terms and Conditions.

BY CHECKING THIS BOX AND CLICKING THE SUBMIT BUTTON, I INDICATE THAT I HAVE READ AND AGREE TO THE SUMMARY AND THE ENTIRE TERMS & CONDITIONSFOR USE OF THIS WEBSITE, AND I HAVE REVIEWED THE PRIVACY STATEMENT FOR THIS WEBSITE.

Insurance Coverage

We accept insurance for PPOs with “out of network coverage”. We do not accept Kaiser, HMOs, Medicaid or Medicare. If you have Blue Sheild, you need to pay in advance as the check will be mailed to you. Payment for services are expected and reimbursment will come depending upon your benefits, deductible and eligibility.
In order to submit to your insurance, please fill out your date of birth & address. Email the front and back of your insurance card to [email protected] Ask your doctor to write a prescription to have neuro-feedback and infrared light therapy as needed due to your condition.

INSURANCE POLICY / DEDUCTIBLE: IF PAYING VIA INSURANCE A COPAY WILL BE REQUIRED PRIOR TO ANY AND ALL SERVICES.

Photo/Video Release

I hereby give permission for images of myself and/or my child, captured during my healing journey at ENSELE through video, photo and digital camera, to be used solely for the purposes of ENSELEs Charity called TheFoundationForNaturalHealing.org’s promotional material and publications, and waive any rights of compensation or ownership thereto.
In consideration of the opportunity to provide certain statements and participate in photography or audio/video taping relating to certain products and services of ENSELE or its affiliated companies (collectively, “TheFoundationForNaturalHealing.org”), I, for myself and, in the case of a minor (the “Minor”), for myself and the Minor in my capacity as the Minor’s parent/guardian, agree as follows: 1. I hereby consent to the recording of statements, photographs, and/or audio or video recordings taken of the Minor or me by ENSELE or its contractors. All statements, photographs, and/or audio or video recordings taken of the Minor or me, by ENSELE or its contractors, may be used by ENSELE for promotional, commercial or other purposes as determined by ENSELE anywhere in the world in its sole discretion. Neither the Minor nor I shall have any right to control the use or publication by ENSELE of the statements, photographs, and/or audio or video recordings. All statements, photographs, and/or audio or video recordings taken of the Minor or me by ENSELE or its contractors, shall be the sole property of ENSELE. Neither the Minor nor I shall receive any compensation in connection with use of these statements, photographs, and/or audio or video recordings for promotional, commercial or other purposes. On behalf of the Minor and myself, I hereby release, waive and discharge any claims of any kind or nature arising out of or relating to the use of the statements, photographs, and/or audio or video recordings against ENSELE or any person or firm authorized by ENSELE to publish said materials (“Publisher”), Such release, waiver and discharge shall also extend to all affiliated companies, shareholders, directors, officers, employees, agents and assigns of ENSELE and any Publisher. This Release shall be binding upon the Minor and me, and our respective successors, heirs, assigns, executors, administrators, spouse and next of kin.  I HAVE READ THIS DOCUMENT AND I UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS ON BEHALF OF THE MINOR AND MYSELF (INCLUDING RIGHTS RELATING TO PUBLICITY AND PRIVACY WITH RESPECT TO THE COMMERCIAL USE OF ANY STATEMENTS, PHOTOGRAPHS, AND/OR AUDIO OR VIDEO RECORDINGS) AND I SIGN THIS RELEASE FREELY AND VOLUNTARILY. 

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© ENSELE ~ All Rights Reserved ~ 2012-2020

Disclaimer: These statements have not been evaluated by the FDA. Not intended to diagnose, treat, or cure any disease.

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