Name *

First Name

Last Name

What are you interested in using Shiftwave for?

Sleep

Pain

Stress / Anxiety

Focus

Energy & Vitality

Longevity

WAIVER *

Please do not proceed without consulting your medical provider if you have had any heart condition, recent surgery, or any implanted medical device such as shunts, stents, meshes, venous filters or aneurysm clips, Additional medical contraindications include unstable angina, pacemaker, epilepsy, detached retina, deep vein thrombosis, and pregnancy. I grant California Shiftwave permission to use my likeness in a photograph, video, or other digital media in any and all of its publications.*

By checking the box, I acknowledge and agree to the terms and conditions outlined in the waiver.