RegenQuantum Cell Factors Consent
Informed Consent, Assumption of Risk, Release & Indemnification
This Informed Consent, Assumption of Risk, Release, and Indemnification Agreement
(“Agreement”) is entered into by and between the undersigned individual (“Client”) and
RegenTherapyTM, including all affiliated entities, partners, contractors, medical directors,
clinicians, distributors, and associated organizations.
1. Nature of the Product and Services
Client acknowledges that they are electing to receive Quantum cell factors–based products,
including proprietary formulations marketed under the RegenQuantum platform (“Products”).
Client understands and agrees that:
● Quantum cell factors are not pharmaceutical drugs
● Quantum cell factors are not FDA-approved to diagnose, treat, cure, or prevent any
disease
● Administration may be considered off-label, investigational, or wellness-based
● Individual responses vary and no results are guaranteed
Docusign Envelope ID: 0106112F-63BA-41A1-8A9E-6D8C3C015635
2. Routes of Administration
Client understands and consents that RegenQuantum cell factors may be administered via one
or more of the following routes, as determined appropriate by the Provider:
● Intravenous (IV)
● Subcutaneous (SQ)
● Intranasal (IN)
● Intramuscular (IM)
Client acknowledges that each route of administration carries inherent risks, which may differ by
individual.
3. Medical Condition & Disclosure Attestation
Client hereby represents, warrants, and attests that all of the following statements are true and
accurate:
● Client is in generally good medical condition
● Client has fully and accurately disclosed all known medical conditions, diagnoses,
surgeries, allergies, and relevant health history
● Client has disclosed all medications, supplements, hormones, peptides, and therapies
currently being used
● Client denies current or recent illicit drug use
● Client denies alcohol abuse or intoxication at the time of administration
● Client is not pregnant, not attempting pregnancy, and not breastfeeding
● Client has no active cancer and is not undergoing chemotherapy or radiation therapy
Docusign Envelope ID: 0106112F-63BA-41A1-8A9E-6D8C3C015635
Client understands that failure to disclose complete and accurate medical information materially
increases risk and releases the Released Parties from liability related to undisclosed
information.
4. Risks, Benefits & Unknowns
Client acknowledges understanding that potential risks may include, but are not limited to:
● Injection-site reactions (pain, bruising, swelling, irritation)
● IV-related complications (infection, infiltration, vein irritation)
● Headache, flushing, dizziness, fatigue, or nausea
● Unforeseen or unknown reactions
Client understands that potential benefits are not guaranteed, responses vary by individual, and
long-term effects may not be fully known.
5. Voluntary Participation
Client affirms that:
● Participation is entirely voluntary
● No coercion, pressure, or guarantee of outcome has been made
● Client has had the opportunity to ask questions and receive satisfactory answers
● Client is proceeding of their own free will
Docusign Envelope ID: 0106112F-63BA-41A1-8A9E-6D8C3C015635
6. Assumption of Risk
Client knowingly and voluntarily assumes all risks, known and unknown, associated with the use
and administration of RegenQuantum cell factors, regardless of route of administration.
7. Release, Hold Harmless & Indemnification
To the fullest extent permitted by law, Client hereby releases, waives, discharges, and holds
harmless the Released Parties from any and all claims, liabilities, damages, losses, costs, or
expenses (including reasonable attorneys’ fees) arising out of or related to:
● The use or administration of RegenQuantum Products
● Adverse reactions or outcomes
● Off-label or investigational use
● Incomplete or inaccurate medical disclosures
Client further agrees to indemnify and defend the Released Parties against any claims brought
by third parties arising from Client’s participation.
8. No Medical Guarantee
Client understands that RegenQuantum Products:
● Are not a substitute for medical care
● Do not replace diagnosis or treatment of disease
● Carry no guarantee of benefit or outcome
Docusign Envelope ID: 0106112F-63BA-41A1-8A9E-6D8C3C015635
9. Compliance & Follow-Up
Client agrees to follow all pre- and post-administration instructions and to promptly report any
adverse symptoms. Client understands they may discontinue participation at any time.
10. Governing Law & Severability
This Agreement shall be governed by the laws of the state in which services are rendered. If
any provision is deemed unenforceable, the remaining provisions shall remain in full force and
effect.
11. Acknowledgment & Consent
By signing, client confirms that they have read, understood, and voluntarily agreed to all
terms of this Agreement.