Program Agreement & Informed Consent

I voluntarily choose to participate in the Peak Brain services selected in this form. Peak Brain provides health and wellness education, coaching, QEEG recording and brain-data education, neurofeedback or biofeedback brain training, and related support. The exact services, schedule, and fees may also be described in an accepted enrollment confirmation, order, or invoice, which is incorporated into this agreement.

Peak Brain teaches clients about brain and behavior patterns and supports feedback-guided training. QEEG information is educational and is not a medical or mental-health diagnosis or a treatment plan. Neurofeedback and biofeedback are training processes that provide information about measured activity; conventional sensor-based services do not send electricity into the brain.

Peak Brain does not provide medical diagnosis, psychotherapy, treatment of a sleep disorder, prescribing, or medication advice. Coaching may address sleep habits, attention, performance, stress-management skills, and self-regulation. I will use a qualified licensed professional for diagnosis, psychotherapy, medication decisions, or other medical care. Peak Brain is not an emergency service; I will call 911 or the appropriate local emergency service in an emergency.

I will provide information that is accurate to the best of my knowledge, follow setup and training instructions, use equipment only as directed, and promptly report unexpected or worsening symptoms, significant changes in sleep, mood, attention, arousal, behavior, seizures, medical status, or medication. I will not start, stop, or change medication based on coaching or training without consulting the prescribing professional.

For remote services, I will maintain a reasonably private and safe training space, a suitable internet connection, and adult supervision when required. Only the enrolled participant or an expressly approved helper may use the equipment, software, account, or protocol. I will not copy, share, modify, sell, or allow others to use them.

Sensor placement can involve scalp, ear, forehead, or body contact, gel or paste, cap pressure, and temporary skin or sensory irritation. QEEG recording or training can be tiring. Some people report temporary headache, fatigue, dizziness, irritability, vivid dreams, sleep changes, emotional or arousal changes, or temporary changes in attention or symptoms. Unexpected or persistent effects should be reported promptly so training can be paused, reviewed, or adjusted and outside care can be recommended when appropriate.

Remote work has additional limitations, including internet or hardware failure, delayed communication, an unsuitable training environment, incorrect sensor placement, or use outside instructions. Results vary. No specific benefit, outcome, timing, or durability is promised. Alternatives include not participating, delaying participation, in-office services, another provider, or licensed medical or mental-health evaluation and care.

I may pause or withdraw consent to future services at any time. Withdrawal does not erase charges already incurred, signed records already created, or equipment-return duties.

I consent to the placement and removal of sensors, electrodes, caps, clips, gel, or paste needed for the selected service, including reasonable touch by trained staff or an approved helper. I may ask that a step stop at any time. I have had, or may request before a procedure, an opportunity to ask questions about the service, equipment, expected experience, risks, alternatives, fees, and privacy practices.

Peak Brain assumes full confidentiality. Peak Brain is a small organization led by a primary provider. Staff and coaches who are enabled to support me may access the information reasonably needed to perform their assigned client-service, equipment, safety, payment, or administrative work. Access remains internal to that authorized service team unless I direct or authorize outside sharing, a contracted provider is needed to operate or deliver the service, or a narrow legal or safety exception applies.

For remote support, Peak Brain may create a separate private Slack channel for me. Only I and the small group of Peak Brain staff or coaches supporting me are intended to have access; a staff member may be added when that person begins supporting me and removed when access is no longer needed. I will avoid posting information I do not want preserved in the service record.

Where HIPAA applies and a vendor creates, receives, maintains, or transmits protected health information for Peak Brain, Peak Brain uses the service in a configuration governed by a Business Associate Agreement when required. Other privacy laws, including GDPR or UK GDPR when applicable, are handled as described in the Privacy Policy. Outside disclosure is limited to the minimum reasonably needed for the permitted purpose.

Where consent is the applicable legal basis, I explicitly consent to Peak Brain processing the brain, health, coaching, communication, and equipment information reasonably needed to provide the selected services. I may withdraw that consent prospectively, subject to lawful recordkeeping, safety, payment, and legal requirements.

The Peak Brain Privacy Policy, revised January 1, 2026, describes collection, staff handling, vendors, retention, security, rights, and permitted disclosures. I authorize Peak Brain to send this signed agreement to the email address I provide. I understand ordinary email carries some privacy risk and will use the private support channel for sensitive service details.

Peak Brain provides a full refund if I give clear written cancellation notice to info@peakbrainla.com within 14 calendar days after purchase; I do not need to give a reason. After that period, if I end a fixed-term program early, Peak Brain will refund the unused portion of the program fee, prorated by the time elapsed from the agreed program start date through the effective cancellation date. For example, ending a two-month program after one month ordinarily produces a 50% refund of that program fee. A fully delivered one-time service has no unused program time.

If Peak Brain loaned equipment to me, every return duty survives cancellation. Any voluntary prorated refund after the initial 14-day period will be processed after all issued equipment has been returned in accordance with Peak Brain’s instructions. Peak Brain may also await return before processing another voluntary refund, except where applicable law requires earlier payment. Ordinary wear is accepted; separately valid amounts for missing or damaged components may be deducted, but Peak Brain will not recover twice for the same loss.

I will follow the other billing, scheduling, rescheduling, pause, and cancellation terms in the written enrollment confirmation, order, invoice, or scheduling notice I accept. No refund is based on achieving or not achieving a desired outcome. A later written term accepted by both parties controls if it expressly changes this section, and mandatory consumer rights remain unaffected.

My service arrangement may involve training in a Peak Brain office, using Peak Brain loaned equipment, or using my own compatible equipment. For office training, Peak Brain equipment remains onsite and I have no return obligation. For client-owned equipment, I am responsible for lawful ownership, compatible hardware, maintenance, safe operation, and any licenses that I supply; Peak Brain does not acquire ownership of my equipment, and the non-return charges below do not apply to it. Peak Brain-provided software, credentials, protocols, or licenses remain subject to their separate ownership and use restrictions.

If Peak Brain loans equipment, Peak Brain determines what the program requires. I may receive a QEEG kit, a neurofeedback kit, or both, and I do not select the specific kit assignment in this agreement. The shipping, inventory, or handoff record identifies what Peak Brain actually issued, and the loan terms apply automatically to each issued kit. All loaned equipment remains Peak Brain property. A QEEG kit is a three-calendar-day loan beginning on the delivery or handoff date shown in the equipment notice, unless Peak Brain approves a different period in writing. A neurofeedback kit is loaned only while the participant is in an active neurofeedback program and becomes due when that program is completed, paused, canceled, or terminated, unless Peak Brain approves an extension in writing.

I will keep every kit secure and in reasonable condition, use it only as instructed, promptly report loss, theft, damage, or malfunction, and return all electronics, sensors, caps, cables, accessories, cases, and other listed components using Peak Brain’s instructions and prepaid label when provided. Ordinary wear from proper use is expected.

Peak Brain provides a 14-calendar-day grace period after a kit becomes due. Non-return billing will not start before both the return due date has passed and Peak Brain has sent return instructions or a written reminder. Beginning immediately after the 14-day grace period, Peak Brain may invoice a $1,000 continued-possession charge for that kit and another $1,000 for each additional 30-day period it remains outstanding, up to a maximum of $4,000 per kit. A QEEG kit and a neurofeedback kit are counted separately. Billing stops when the carrier records its first acceptance scan or Peak Brain confirms hand delivery.

The parties acknowledge that a configured QEEG system has an approximate retail price of $7,500 and that loaned kits include electronics, accessories, setup, and associated software licensing. The non-return charges are intended to address continued possession and loss of use, not to punish. Charges do not transfer title, ownership, credentials, protocols, or software-license rights, and Peak Brain may disable software or accounts. Peak Brain will not recover twice for the same loss, and the non-return charges for one kit will not exceed $4,000.

By typing my full legal name and submitting this form, I intend to sign electronically and agree that the electronic record and signature have the same effect as paper. Peak Brain will send a copy to the email address I provide and may retain technical signature evidence such as the date, time, agreement version, browser information, IP address, and a record-integrity hash.

This agreement, together with the accepted written enrollment and payment materials, is the complete agreement on these subjects. If a provision is unenforceable, the remainder continues to apply to the extent permitted by law. No term waives a right that cannot lawfully be waived. The law applicable to the responsible Peak Brain entity and mandatory consumer protections apply.