Autism Clearing Contract | autism-consulting-s

Autism Protocol Contract (sample)

Autism is a syndrome which is diagnosed through a criteria of an impairment in communication and social interaction. Adults on the autism spectrum inform us that the desire to communicate is always there and that the words they want to say are present in their mind but there seems to be a wall which they cannot break through. The autism protocol removes the blockages in the body that form this wall through the use of the quantum biofeedback with a device called the SCIO.

A complete autism protocol consists of

Three initial sessions consisting of 3 introductory sessions of 2 hours each – once a week for 3 weeks. These get the body ready to receive the frequencies during the protocol.
The autism protocol which takes anywhere from 30 to 48 hours depending on the number of miasms, viruses and chromosomes involved for the specific individual. Each case is unique. The protocol runs for two days each week (Wednesdays and Thusdays) until complete and is left running on biofeedback overnight Wednesday evening.
12 monthly follow up sessions of 2 hours each to repair the trauma experienced by the body and clear any co-morbids that have developed because of the presence of the autism.

The fee for this service is $100.00 per hour. We charge for the actual time a therapist works with the client, not for the extra hours the Scio is left running on biofeedback. Payments are due at the end of each session. All sessions are invoiced via and paid through paypal. If you are in Canada, we also accept payment through e-transfers from your bank account.

Initial and follow-up sessions can take place with the individual present in the office, or through subspace anywhere in the world. The protocol itself is always done through subspace because of the amount of time it takes.

Consent: I have read and understand the contents of this service.

I (please print) _______________________________________________________contract

Autism Consulting Service to complete the full autism protocol for myself / my child

__________________________________________________________________________.

Consumer/Guardian Signature_____________________________________ Date ___________

Please fill in all blanks

Name of client in full:

__________________________________________________________________________

Birth date (day/month/year)

__________________________________________________________________________

Birth place (nearest major city)

__________________________________________________________________________

Parent/Guardian Name (if applicable)

__________________________________________________________________________

E-Mail Addresss

__________________________________________________________________________

Address

__________________________________________________________________________

Phone Number:

__________________________________________________________________________

Payment Method

__________________________________________________________________________

To get a copy of this contract to fill out an submit to Autism Consulting Service, please ask through exgr@shaw.ca.