HERB PRODUCTS & HOPE FOR YOUR ENTIRE FAMILY - FARM & HUMAN!!!!
  • Home
    • FAQ
    • Liability LImitation, Services, Conditions of Use
    • Order Form
    • What Really Matters >
      • Other Links
  • Products
    • Animal Herb Mixes (DWA, GI Soother...)
    • EMF Shields BE 5G READY
    • Essential Oils
    • Extracts, Infusions
    • Human Supplements & Teas
    • Salves Skin Shampoo Soap
    • Single Herbs
  • Services
    • Consult Intake Form - Wellness
    • Consultations - Wellness
    • Iridology (wellness assessment)
    • QT Energy Medicine
  • Dairy Goat Evaluation
  • Link to our Farm
  • Blog
  • Contact Us

You can now also find this form at:  discountdrchristopher.com

 Consultation Intake Form - Fir Meadow LLC

 Please make a copy of this form and fill out and email to firmdw@gmail.com after you have purchased a consultation.  Please note that per the FDA no claim is being made that I nor herbs or alternative therapies diagnose, treat, cure or prevent any disease.  I also make no claim to be a licensed doctor, veterinarian or other licensed medical professional, but will educate in traditional uses of herbs and alternative products and therapies which is allowed under the Ninth Amendment.   Your submittal of this form implies you are accepting and consenting to alternative educational services and the following clause required for service provision. “Except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless Katherine A Drovdahl, her family, agents, heirs and businesses including but not limited to Fir Meadow LLC  from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s) including current, previous, and any subsequent communications on this or other wellness topics on any creature or human.  It is the purchaser's responsibility to be sure that educational & herbal suggestions are cleared as allowable for use with regulatory authorities in the case of competing human or animal athletes engaged in competition.  It is the purchaser's responsibility to research & be aware of any possible or potential drug - herb interactions or contraindications with their doctor, veterinarian, pharmacist or other licensed drug specialist. ”   If any of these statements are disallowed by the current rule of law then the remaining statements shall still be in full force and the document remain intact.    Only 1 major or 2 minor conditions per creature/human/herd will be covered per consultation.  Price includes 1 - 2 short emails if clarification is needed within 1 business day of receiving your educational session/email.  Followups available at reduced costs for the same creature/human/herd issue.
Purchaser Name:_______________________________ Date:__________________________
Phone # to call:______________________OR Email to use:___________________________
Consultee Name:________________________ConsulteeSpecies:_______________________ Breed:____________________ AGE:________  Height:___________ Weight:_____________
Sex:____________Pregnant?___________  Lactating?_________ fixed/altered?___________
Health conditions (past/present):___________________________________________________________________
________________________________________________________________________________________________________________________________________________________________
Current diet/frequency/supplements_______________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Drinking water (well,city, softener, RO, other)__________________________________________________________________________

Concern/s wanted to cover: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Goal/s:__________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________

Your purchase of any service or product from Fir Meadow LLC implies your acceptance of all statements on this consultation Intake Form Including all disclaimers at the top of the form.  Your signature implies that you have read and accept all pages of this form including the disclaimer.

Signature:____________________________________  DATE____________________________



 Give Thanks to the Lord for He is good,  His mercy endures forever!


Copyright ©  1999-2023 Fir Meadow LLC  All Rights Reserved 
  • Home
    • FAQ
    • Liability LImitation, Services, Conditions of Use
    • Order Form
    • What Really Matters >
      • Other Links
  • Products
    • Animal Herb Mixes (DWA, GI Soother...)
    • EMF Shields BE 5G READY
    • Essential Oils
    • Extracts, Infusions
    • Human Supplements & Teas
    • Salves Skin Shampoo Soap
    • Single Herbs
  • Services
    • Consult Intake Form - Wellness
    • Consultations - Wellness
    • Iridology (wellness assessment)
    • QT Energy Medicine
  • Dairy Goat Evaluation
  • Link to our Farm
  • Blog
  • Contact Us