- Participation in any corporate/occupational health and safety foot screening and orthotic assessment program is at my own risk and discretion. I acknowledge that I have the ability to seek medical advice from my primary care physician or other licensed medical professional prior to participating in a foot screening, but that physician consent is not required. I understand that it is my sole decision and responsibility to obtain, or waive my right to obtain, medical advice from a licensed medical professional prior to participation. I further acknowledge that the opinion of a licensed medical professional is not a guarantee against illness, injury or death, which could result from my participation.
- I acknowledge that Nolaro24, LLC does not review my medical records, does not provide any medical advice, and that any advice I may receive from Nolaro24, LLC is not medical in nature.
- I agree that participation in any on-site employee foot health screenings, or use of products supplied by Nolaro24, LLC is voluntary and is not a requirement or expectation of my job, nor does my employer derive any benefit from my participation. Likewise, I understand that I am under no obligation to participate, nor am I being compensated to do so.
- I understand that participation in any Nolaro24, LLC’s on-site corporate foot health screenings may include group participation and that, upon request, I may be able to arrange a private session or decline participation at my sole discretion at any time.
- In some situations, I may also choose to engage in remote consultations with Nolaro24’s board certified practitioners. In doing so, I may be asked to provide Information that will be necessary to evaluate my feet for the determination of my foot type and to determine recommendations for foot orthotics. This information may include images and videos of my feet and personal information related to any complaints of pain or physical limitations related to my feet and orthotic use. This data and information may be transmitted to Nolaro24, LLC via text or email, or both. I understand that such methods of data transmission are NOT HIPAA compliant and information shared during transmission may not be secure, and I agree do so solely at my own risk and discretion.
- I have been advised that any personal information that I provide to Nolaro24, LLC’s staff and affiliates, whether through on-site screenings or through remote assessments, will be kept confidential and released only with my prior authorization and/or used for research purposes with my name withheld. Participants are requested not to provide any personally identifiable information.
- I understand that during the course of any foot screening program I will be offered information and suggestions for use of certain prefabricated (Over-the-Counter) QUADRASTEP foot orthotics, and shoe recommendations, based on the conclusions made regarding my foot type. I acknowledge that participation in any foot assessment process or program does not require that I agree to proceed with such recommendations and doing so is of my own volition.
- Release of Liability. I hereby release, discharge and hold harmless, Nolaro24, LLC, and their affiliates, predecessors, successors and assigns, agents, directors, officers, shareholders and employees (both past and present) of and from all liability, claims, losses, and demands (including attorneys’ fees and costs), arising out of or related to any loss, damage or injury, including death, to my person or property from any cause whatsoever, including negligence, that may arise from or otherwise be related to my participation with any Nolaro24, LLC foot screening programs and the use of Nolaro24, LLC QUADRASTEP foot orthotics. This Waiver including the release is binding on my heirs, executors, administrators, assigns, agents, attorneys, and representatives.
This is a release of liability. I have carefully read and fully understand all the provisions of this release, and sign this as a free and voluntary act. I also acknowledge that I have not relied upon any representation or statement, written or oral, not set forth herein.
Note: Should any part of this agreement be found by a court of competent jurisdiction to be in violation of applicable laws, regulations or public policy, then such part shall be removed, and the remainder shall remain in full force and effect.