Please read and complete the form below before trying the Lucia N°03 Light Experience.
Quantum Light Experience
Informed Consent Waiver
At Quantum Light Experience LLC and in other light salons around the world, theLucia N°03 Hypnagogic light experience is not specifically intended to cure, treat,prevent or heal any disease, injury, or illness. I understand that if I have a health problem, or think I may have a health problem, I will be referred to a licensed professional for further assistance upon my request.
I understand the services provided by light attendants at Quantum LightExperience LLC may cause certain side effects such as:
– fluttering of the eyes
– feeling like you have transcended or left your body
– visions, symbols, and/or emotions may arise
– in rare cases (including undiagnosed epilepsy) a seizure may occur
I understand that these effects may arise through no fault of Quantum LightExperience LLC or it’s light attendants. If I have any concerns about any of thesepossible side effects, I will keep light attendants at Quantum Light Experience LLCfully advised about my concerns so the intervention may be terminated if necessary or revised to minimize any discomfort.
I understand that I am fully responsible for my own decisions and fully aware of thepotential side effects. I will let the light attendant know if I feel uncomfortable at anypoint and the session will be ended.
I understand that using the light machine is not advised if the client:- is under 18 years of age
– is pregnant
– has a history of epilepsy or seizures
– has a history of severe anxiety, or other psychosis
– is under the influence of any drugs or other mind-altering substances
I understand the above statements and it is my choice to participate in this experience.
If I have any type of medical condition or if I am on any medication, I understand that it is my responsibility to consult my physician before engaging in this experience.