Version 1.0 — Effective 2026-04-30 — WIZDOM AI / gil@gilluxenbourg.com
Before working with WIZDOM AI, every patient is asked to read and acknowledge the following statements. This acknowledgment is required either before payment or as the first step of onboarding immediately after payment. It exists to make absolutely clear what WIZDOM is, what it is not, and what responsibilities remain with you and with your treating physician.
Please read each statement carefully. Tick each box to indicate that you understand and agree.
[ ] 1. I understand that WIZDOM AI provides patient education, protocol design, and patient guidance. WIZDOM does not provide medical treatment, diagnosis, or prescription, and nothing produced by WIZDOM should be interpreted as medical treatment, diagnosis, or prescription.
[ ] 2. I understand that Gil Luxenbourg is a Ministry of Health-licensed Medical Cannabis Instructor and patient educator with more than twenty years of experience, including his role as Patient #7 in Israel's medical cannabis program (2004) and founder of the Israel Medical Cannabis Association (2005). He is not a physician, clinician, or licensed medical practitioner of any kind.
[ ] 3. I will continue to consult my own physician about my health and any conditions I am being treated for. I will disclose my participation in WIZDOM to my treating physician or physicians.
[ ] 4. I will not stop, start, change, or adjust any prescribed medication on the basis of WIZDOM materials, conversations, or protocols without first consulting my own physician.
[ ] 5. I understand that cannabis affects each person differently. Results from any educational protocol are not guaranteed. Side effects, interactions, and unexpected reactions can occur.
[ ] 6. I will report any adverse effects, side effects, or concerning symptoms to my physician promptly. I will not rely on WIZDOM for urgent or emergency medical concerns.
[ ] 7. I confirm that I am of legal age in my jurisdiction and that I have lawful access to medical cannabis where I live, or that I am working with WIZDOM in an educational capacity only and not for the purpose of obtaining or using cannabis where it is illegal.
[ ] 8. I understand that WIZDOM AI is not licensed to provide medical advice in any jurisdiction, and that nothing in our work together constitutes the practice of medicine.
[ ] 9. I have read and agree to the WIZDOM Privacy Policy and the WIZDOM Refund Policy, both dated 2026-04-30.
By typing my name below, or by clicking "I agree" on the electronic version of this form, I confirm that I have read each of the nine statements above, that I understand them, and that I agree to them. I confirm that I am entering this engagement of my own free will and that I retain full responsibility for my own medical decisions.
Patient name: ________________________________
Date: ________________________________
Electronic acceptance: This form may be accepted electronically. An electronic acceptance, including a typed name and date submitted through the WIZDOM onboarding system, has the same legal effect as a handwritten signature.
Questions about this acknowledgment should be directed to gil@gilluxenbourg.com prior to acceptance.