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Voluntary Participation and Consent to EEG Neurofeedback
This office offers Neurofeedback Training, also known as qEEG Guided Biofeedback training, to clients requesting such services. The training is offered to children and adults, either self-referred or identified by parents, physicians, teachers, or other referral sources, as having conditions shown to be responsive to this type of training. These conditions are generally thought to be those that appear to be associated with irregular brain electrical activity where there is also clinical and research evidence to suggest neurofeedback training as a viable treatment approach.
Our staff has education, training, and experience in neurofeedback and in EEG technology. Neurofeedback training has been the subject of more than 50 years of research and clinical study. We recommend the training on the basis of our observations of improvement in clients with similar conditions. We use standard methods to determine the proper training program and to measure progress during and after training. Neurofeedback is, however, considered an experimental approach and therefore we require client or parental informed consent for this training.
It is important to understand that a neurofeedback assessment is NOT the same as a “clinical EEG,” which is used in medical diagnosis to evaluate epilepsy or to determine if there is a serious brain pathology, such as a tumor. The neurofeedback computer records the manner in which a particular person’s brain waves function. It is not designed (and we do not use it) to diagnose medical conditions.
I understand neurofeedback training requires the placement of sensors on my scalp for the purpose of recording my EEG. This signal is used to provide video displays and audio signals.
I understand some individuals have reported training may affect the body’s response to medications. I understand I should not stop or alter taking my medications without consulting with my medical professional. I should continue other therapies until otherwise advised by my medical professional. Should new symptoms develop, it is my responsibility to inform my health care providers, including my neurofeedback practitioner.
Before beginning this neurofeedback program, I and/or my child can commit to and have time for our training plan. Successful attainment of my treatment goals is dependent on consistent attendance at neurofeedback training sessions
When I sign this form, I am indicating that I understand the information that it contains. When I agree to participate in this program, I and/or my child are not obligated to complete the training, if for any reason I believe it is not in my or my child’s best interest. This means I may discontinue participation at any time. Training and test results will be made available to me.
If I, or anyone else who will use this machine, are subject to any form of seizures, epilepsy, or visual photosensitivity, I will notify The Brain Wave Center prior to starting Neurofeedback training.
We make no promises, assurance, or guarantees regarding the effectiveness of this program. Individual results may vary.
Yes, I understand and agree to the terms of this document.
Yes, you may administer standard tests.
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