Disclaimer: By submitting this form the patient and any of patient's agents or guardians acknowledge that The Awareness Network does not promise, guarantee, or warrant the success of any treatment. The Awareness Network is not liable for the outcome of any treatment. Additionally, the Awareness Network is not responsible for sustaining treatment, the completion of treatment, and the continued payment of services in part or in whole in the future. By accepting this form, the Awareness Network does not promise or guarantee any assistance. Any assistance provided by The Awareness Network is not a promise or guarantee of future assistance. By submitting this form the patient forever releases and holds harmless The Awareness Network for any negligent or reckless act or omission resulting in damages to patient.  Healthcare decisions should be made solely between patients or patients’ guardians and mental health professionals. The Awareness Network does not attempt to practice medicine or give specific medical advice, including advice concerning the topic of mental health. If you believe you or another individual is suffering a mental health crisis or other medical emergency, contact your doctor immediately, seek medical attention immediately in an emergency room or call 911.