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The Formation Protocol is a proprietary performance and embodiment system. It is not massage therapy, physical therapy, chiropractic care, occupational therapy, athletic training, or any other licensed or regulated health care modality. It does not fall under the purview of the Louisiana Board of Massage Therapy, the Louisiana Physical Therapy Board, the Louisiana State Board of Medical Examiners, or any equivalent regulatory body in any jurisdiction.

The practitioner does not diagnose any condition, does not treat any injury or illness, does not perform soft tissue manipulation, does not perform joint mobilization or manipulation, and does not claim any therapeutic, rehabilitative, or medical outcome. No soft tissue mobilization, myofascial release, or clinical manual therapy technique is performed by the Formation Protocol practitioner in the coached delivery format.

What the Formation Protocol practitioner does: applies directed loading pressure using instruments guided by the client's own hand under verbal instruction; applies structured resistance through a load-hold-release sequence; maintains fixed contact points at external anatomical landmarks to provide proprioceptive reference; and conducts a verbal and physical coherence sequence. These actions constitute a performance coaching and embodiment practice — not a clinical or regulated service of any kind.

I understand this distinction completely. I am not seeking clinical treatment. I am engaging a performance and formation system, and I enter it with that understanding.

I affirm that I am not seeking, and the Formation Protocol practitioner is not providing, any of the following: massage therapy of any kind; soft tissue mobilization or manipulation; myofascial release; instrument-assisted soft tissue mobilization (IASTM) applied by the practitioner's hand or instrument directly to my tissue; joint manipulation or mobilization; physical rehabilitation; occupational therapy; athletic training services as defined by any licensing board; or any service that constitutes the practice of medicine, physical therapy, chiropractic, or massage therapy under the laws of Louisiana, Ireland, or any other applicable jurisdiction.

I understand that if I am seeking clinical treatment for any injury, condition, or diagnosis, I should consult a licensed healthcare provider. The Formation Protocol practitioner will refer me to a licensed provider if clinical care appears indicated, and will not attempt to provide clinical care themselves.

I understand and affirm that I am not presenting to the Formation Protocol practitioner for the treatment, management, rehabilitation, or assessment of any medical condition, injury, diagnosis, or symptom. The Formation Protocol does not treat medical conditions. It does not address diagnosed physical or psychological disorders. It is not a substitute for medical care, physical therapy, psychotherapy, or any other licensed clinical service.

If I have a current medical condition, injury, or diagnosis, I understand that this work does not treat, improve, or address that condition, and that I remain solely responsible for managing it through appropriate licensed care. The existence of a condition does not make this work a treatment for it.

I further affirm that during this intake process, no diagnosis has been made, no condition has been assessed, and no clinical recommendation has been given to me by the Formation Protocol practitioner. The questions in this application exist to screen for safety contraindications and to understand my physical history — not to evaluate or treat any condition.

I am submitting this application and, if accepted, entering this work entirely of my own free will. I have not been pressured, coerced, or induced by any misrepresentation of what the work is or what it produces. I understand that I may withdraw from any session at any time without penalty. My participation is voluntary at every stage.

I enter this work with no expectations beyond what has been explicitly described in the Formation Protocol materials. I have not been promised specific outcomes, results, timeframes, or guarantees. I understand that formation is a process, not a transaction, and that results vary between individuals based on their consistency, readiness, and engagement with the work.

I understand that the Formation Protocol involves specific, bounded physical contact as described below. I consent to this contact as a component of the performance and embodiment work I am voluntarily entering.

The physical contact in this work consists of: (a) the practitioner holding fixed contact points at external anatomical landmarks — such as the sacrum, scapula, iliac crest, or occiput — to serve as proprioceptive reference points while the client moves; (b) the practitioner applying directed resistance against the client's own active force in a structured load-hold-release sequence; and (c) sustained bilateral contact during the coherence sequencing phase to facilitate a state consolidation. In the coached delivery format, fascial loading is applied by the client's own hand, directed by the practitioner's verbal instruction — not by the practitioner's instrument or hand.

This contact does not constitute soft tissue manipulation, myofascial release, trigger point therapy, massage, joint mobilization, or any regulated manual therapy technique. The practitioner is not working on tissue — the practitioner is working with the body's own force, resistance, and proprioceptive system.

I also understand and accept that sessions require attendance in briefs or compression shorts. This is a non-negotiable protocol standard that allows the practitioner to observe postural and movement patterns accurately. I have not been misled about the nature of the physical interaction.

I understand that this work involves physical loading, resistance, and directed movement, and that as with any physical activity, there is inherent risk of discomfort, muscle soreness, or injury. I voluntarily assume these risks. I acknowledge that the practitioner has disclosed the nature of the physical work and I accept it with full knowledge. I will inform the practitioner immediately if I experience pain, discomfort, or any symptom that concerns me during a session.

I confirm that I have accurately disclosed all known physical conditions, injuries, surgeries, and contraindications in this application to the best of my knowledge. I understand that withholding relevant health information places me at greater risk and releases the practitioner from responsibility for any harm that results from undisclosed conditions. If my health status changes between submitting this form and attending a session, I will notify the practitioner before the session begins.

To the fullest extent permitted by applicable law, I release and hold harmless Dr. Edwin H. Adams, Matt Norrby, The Aesthetics Lab, and DisruptComfort from any claim, loss, damage, or liability arising from my participation in the Formation Protocol, including but not limited to physical discomfort, muscle soreness, exacerbation of undisclosed conditions, or any other outcome resulting from my voluntary participation. This release does not apply to gross negligence or intentional misconduct.

I understand that the information provided in this application will be stored securely and used solely by the practitioner for the purpose of reviewing my application, conducting sessions, and maintaining my formation record. This information is not sold, shared with third parties, or used for any marketing purpose without my explicit consent. My application and session records are treated as confidential. This work does not involve Protected Health Information (PHI) as defined under HIPAA — it is a non-clinical performance service.

I confirm that I am 18 years of age or older and that I am legally competent to enter into this agreement on my own behalf. I am not under the influence of any substance that impairs my judgment or my ability to give informed consent. I have read and understood all of the above agreements.