Free and Healthy Children International

Free and Healthy Children International Patron Registration and Consent to Research

ACCESS - EDUCATION - RESEARCH
Free and Healthy Children International (FHCi) welcomes Patrons like you who are invested in HPx for the health of their families.

If you have not already done so, prior to completing your registration, please review All HPx Programs.

Currently all HPx Programs are under research to verify safety and efficacy of HPx, and for the advancement and increased public awareness of, and access to HPx. FHCi provides access to HPx through Patronship with FHCi and your Consent to Research.

For the security of your individual privacy, that of our HPx Practitioners, and HPx research, the data is stored in your Patron Portal within the private membership platform of FHCiA-PMA.

FHCi is a public 501(c)3 charity and is open to all Patrons who complete the following Patron Registration and Consent to Research, with accompanying minimum tax-deductible donation.

Please check here if you are an existing FHCi Family
Yes, I am an existing FHCi Family
Family Registration:

Please enter the information of the family member that will be the person who will be establishing your Patron Portal and will be the person for communication with FHCi .
Name *

First Name Last Name

Email *

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Mailing/Shipping Address*

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FHCi Patron Agreement, I pledge: *

I and my family are invested in the continued access to HPx. By becoming a Patron I understand that I will need to become a member of the affiliate FHCiA-PMA to access HPx Practitioners and HPx Programs. I affirm that I DO NOT represent any State or Federal agency whose purpose is to regulate and approve products. I affirm that IF I DO belong to any media outlet I WILL NOT misrepresent any information regarding homeopathy, homeoprophylaxis (HPx), or FHCi. I affirm that through this relationship I WILL NOT carry out any mission of entrapment or investigation.
I pledge Patronship to FHCi. *

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Consent to FHCi Research*
For all new and existing families All HPx Program dosing dates of, and responses to, are entered into research. Within restricted date ranges certain HPx Programs will be activated for more comprehensive research, this includes Intake and Exit Interviews. HPx Programs currently registered for prior to and after that date range identified will be excluded from the comprehensive research. Your HPx Practitioner will advise you of the dates when these programs would be activated. Reasons to activate certain HPx Programs include seasonal conditions, active outbreaks, topics of interest. etc.
Consent: *

I understand that this form covers consent to HPx Research by FHCi of myself and my immediate family members entered into our Patron Portal for the participation in any and all HPx Programs offered by FHCi. I understand the purpose of this research is to determine the efficacy of program nosodes for promotion of health and reduction in disease expression. I understand that by entering into this research I may in fact get the disease or some expression of the disease, as there is no promise of prevention or cure. I understand nosodes have been a part of regular homeopathic clinical practice for over 200 years, but may not have been previously tested on humans or animals. I consent to receive and self-administer the nosodes supplied with my selected HPx Program Kit(s), and I understand that there may be mild short-lived immunological symptoms indicating the immune system is resonating with the nosode, and that previously unaddressed chronic conditions may activate. As I have voluntarily agreed to participate in HPx research, I release FHCi from any liability due to any health outcomes. If an adverse event is suspected, I have the right to submit a report through the FHCi Adverse Event Reporting System. I understand that I can stop the program at any time and pursue any other treatment modality of my choice. I agree to contact my HPx practitioner in the case of symptoms that are concerning to me: i.e., prolonged, aggravated symptoms, or reactivated conditions. I understand that I can withdraw this consent at any time in writing through Patron Support within my Patron Portal. I understand it is my responsibility to complete all forms as outlined in the HPx Programs, and accurately enter dosing dates, remedy responses, and changes in baseline health as per program parameters. I understand I have the ability to access the secure Patron Portal within my membership in the PMA, where my, or my dependents’ Personal Health Information (PHI) and non-PHI information will be stored. I understand that in entering data I must be truthful to the best of my ability to do so. I understand that my or my dependent’s Personal Health Information (PHI) will be protected under the secure holding of the Patron Portal and will not be included in any publication or be available to any public, private, or government agency. I consent to releasing all non - PHI (my or my family member's age, sex, health outcomes and previous health history) in relation to data generated from my/our participation in any HPx program to FHCi for review, analysis, and publication.
Your signature confirms your consent to research *

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FHCi donation to complete my Patron Registration *

USD We always appreciate additional donations, remember they are tax deductible.
Discount code for previous FHCi Patron
Discount Amount: $0
Additional donation for research choose amount:
$ 5

$ 25

$ 100

Other: $
PayPal Fees

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Total: $

Free and Healthy Children International Patron Registration and Consent to Research

Family Registration: