Research on the Causes of Symptoms Associated with Perimenopause-Research Service Contract

Brigette's Natural Healthcare Research and Laboratory Division

RESEARCH ON THE CAUSES OF SYMPTOMS
ASSOCIATED WITH PERIMENOPAUSE
~If you are currently experiencing a medical emergency, call 911~

Initial Virtual Research Project

If you are a Licensed Medical Practitioner and would like to have research conducted about natural health remedies associated with perimenopause,
please complete the following form and submit $5,500 USD payment for services to brigettebrenda@aol.com via Paypal or Dwolla with the following message in bold:

I understand this natural healthcare research service provider (Brigette's Natural Healthcare Academia Research Firm) is to provide me one (1) five (5)-page document to include suggestions to approach the underlying cause(s) of the symptoms I have indicated in the form submission.
I understand this is a natural healthcare research service and a not medical service that diagnoses diseases and/or administers prescription medications.
I further understand there is no refunds and no guarantees associated with the outcome of the research findings.

Once completed form (in English) and payment are received, practitioners will be provided a five-page (5) document within 20 business days of submission
to include research findings on how to approach the symptoms related to perimenopause.
If the practitioners desire further research, click here

Client Full Legal Name: Title:

Contact Information:
To maintain confidentiality, the email above is where the research findings will be emailed.

RESEARCH FOCUS: Here, specify the focus of the research requesting. If left blank, these factors may not be considered for the findings:

Work Hours: Types of Hobbies:

Age Group: Gender: Weight: Height: Eye Color:

Blood Pressure:    Blood Work (Results):

Cholesterol Level:     Urine Description/Frequency:

Food Allergies:     Environmental Allergies:

Topical/Skin Allergies: Medication Allergies:

Medications Intake (Dose/Frequency) Effect:

Supplement Intake (Dose/Frequency) Effect:

Medical History of Sample:

Diagnostic Test: Mammogram/Bone Density (State/Results):

Pregnant/Menstrual Cycle Duration/Flow:

Perimenopause Diagnosed by a Licensed OB/GyN Based on Hormonal Panel:

Origin/Trigger of Perimenopause:

Recreational Habits (Alcohol/Tobacco/Street Drugs/Frequency):

Food Consumption Preference: Vegetarian, Vegan, Semi-Vegetarian/Pescetarian, Omnivore (select one):

Family Medical History:

Instructions: Type An Explanation/Focus fter Each Research Inquiry. Do Not Remove the Text in the Textbox:

Explain the Purpose: (a) Of Life: (b) For a Rebirth:

Symptom 1 (Describe~Location, Duration, Frequency):

Symptom 2 (Describe~Location, Duration, Frequency):

Symptom 3 (Describe~Location, Duration, Frequency):

Symptom 4 (Describe~Location, Duration, Frequency):

Symptom 5 (Describe~Location, Duration, Frequency):

By pressing the submit button, I agree to the terms indicated on the Perimenopause Research webpage (Brigette's Natural Healthcare Academia Research Firm~hereby known as the "Firm") and with the payment terms. I also certify that all the information presented in this submission is true, and I consent to the use of disclosure of the information submitted for healthcare research services. I acknowledge that the email address provided is secure, and that the Firm cannot and will not be held liable for any breach in the email system or of the information or misinformation transmitted using this electronic platform. I further understand the Firm cannot or will not be held legally liable for any symptoms (prior, current, future) to include symptoms that have been indicated or omitted in this transmission associated with the condition or disease of which is being researched. This Service Agreement and any dispute there under shall be governed by the laws of the State of Georgia, USA.

The Firm's Research Projects: The Firm Would Appreciate Your Participation. Thank You.