Legal Disclosure

We’re glad you’re taking this first step on your Road to Total Wellness! Please read through the terms below and check each section as indicated.

Click here if you wish to view and download the Legal Disclaimer & Scheduling Policy in PDF Format.

21st Century Total Wellness, LLC is registered with the state of Indiana as a naturopathic clinic providing consultation in the field of functional nutritional, as well as nutraceutical, herbology, homeopathic consultation, manual therapy, and other aspects of natural intervention.*
- I Agree
No service or information available from 21st Century Total Wellness, LLC should be misconstrued as medical advice, prescribing, diagnosing, or intervention for any medical condition. All information available from our website, brochures, and other collateral material are offered as educational material for your review.*
- I Agree
You (the reader, current/routine client, prospectus client) take full responsibility for all application(s) of such education material and interventions. At no time will 21st Century Total Wellness, LLC represent themselves as diagnosticians or any other representation, which would be found to be unlawful or unethical.*
- I Agree
All decisions by you (the reader, current/routine client, prospectus client) to apply such educational material is done so at your risk and responsibility to follow all directions indicated in material as well as the supervision of a qualified provider. As a courtesy, we offer assistance by phone at no fee to any and all inquiries specifically relating to the understanding of this disclaimer and all education material available from 21st Century Total Wellness, LLC.*
- I Agree
You (the reader, current/routine client, prospectus client) take full responsibility/liability and voluntarily relinquish all rights for any/all legal recourse against: Prater, Property, 21CTW LLC, and all individual’s this is understood, and agreed by the reader, current/routine client, prospectus client and confirmed by your decision to drive/park, walk on/within any and all areas of main office of Dan Prater, downstairs/stair case, hallway and Photon Genius Room on the property of 12514 Parrish Ave Cedar Lake, Indiana 46303*

Print Full Name
First Name*
Last Name*
All out of state and Tele Medicine consultations must be pre-paid. If you have not received PayPal invoice please text 219-613-1161 or email dp@21ctw.com: PIM (Which means please invoice me).

Once your Health History, Health Appraisal Questionnaire and this Legal Disclosure form(s) are submitted you will receive email or text confirmation.

Please text 219-613-1161 or email dp@21ctw.com to confirm your appointment date/time before arriving at our office.
Initials*
Email Address*
Enter Email Confirm Email
Phone*
Please check all areas that apply to you.*
- Health History
- Health Appraisal
- HMS Order
Comments or Questions:*
The checkboxes, your signature (name) and initials confirm your understanding and agreement to all areas checked.*
- I Understand & Agree
Let us know you are human