Please fill out the following Health Declaration form to be one step closer to starting your healing journey with Ebony Healing.
This form is intended to define the conditions for both you the client (Eboneer) and Ebony Healing’s Organizational Rights to conduct natural/ spiritual remedies for their users. This Consultation form will be used by Ebony Healing Organization to identify the purpose of the healing remedy from the information obtained above so that we can conduct unique and impactful Ebony Healing Remedy for you. By signing below, you confirm that the information you have provided during this consultation is accurate and that you overstand the Disclaimers below. Furthermore, you agree to Ebony Healing’s Organizational rights to conduct an Ebony Healing Detox Remedy for all current and future orders.
Please Note: Ebony Healing Herbal Remedy will be provided in its herbal form for orders being shipped. We provide the convenience of making one week herbal remedy for pick up/drop off orders. Processing time may take up to 3 Business Days before shipping or delivering your order.
Disclaimers: This product information is not intended to replace or contradict the services of a healthcare Specialist/Physician in the treatment of any ailment/disease. Our organization does not submit to the jurisdiction of the Food and Drug Administration, therefore no FDA evaluation has been performed on any of our products. Out product are not intended to diagnose, treat, cure or prevent any disease. Any application of the information herein is at the reader’s discretion and the sole responsibility of the individual who has chosen to use this herbal product. Results may vary based on ethnic background and commitment to Ebony Healing's individual recommended dosage.
I declare that the information I’ve provided is accurate & complete *
I read & agree to have been provided Informed Consent and Full Disclosure Information*
I agree to the terms & conditions.*
If you selected over five (5) or more health concerns or selected any of the following health concerns below, we recommend the Gold Remedy package:
Autism,
Cancer (Any type)
Cardiovascular/ Heart Concerns
Crohn's Disease
Diabetes,
Edema / Inflammation
Epilepsy
Fibromyalgia
GERD / acid Reflux
High Blood Pressure
Irritable Bowel Syndrome / Stomach Problems
Liver Disease (Any Type)
Lupus
Multiple Sclerosis
Osteoporosis
Pancreatitis
Sickle Cell
STD (Any type)
