Start Your Rental

Complete this agreement to start your rental. Once we receive it, we'll send you a secure payment link and confirm your shipping dates.

Rental Agreement & Client Informed Consent

Please read the full agreement below before signing — scroll within the box to see the whole thing. When you're done, scroll down past the box to find the form, which asks you to acknowledge each numbered point and sign both documents by typing your name.

You’ve reached the end of the agreement — scroll down to fill out and sign the form below.

Complete the agreement

    Your Information







    Choose a package

    Please choose one. You can add time to your rental at any point during your training.


    Personal — $599 — 12 sessions over 4 weeksGroup — $769 — 22 sessions over 4 weeksUnlimited — $899 — unlimited sessions over 4 weeksFamily Shared — $999 — unlimited sessions over 5 weeks

    Alternate contact

    Please list an alternate contact who might be responsible for the system in case we are unable to reach you.



    Acknowledgements


    I accept full responsibility for the safety and return of the equipment in the same condition it was received.


    I have read and understand the Essential Notes section above.


    I understand that I may not generate income from providing NeurOptimal® sessions with this equipment unless I've discussed it with Whole Family Neurofeedback ahead of time.


    I accept personal responsibility for the care of the equipment and understand the replacement values listed above.

    Sign the rental agreement


    By typing my full legal name below, I agree that this constitutes my electronic signature and has the same legal effect as a handwritten signature.


    Sign the client informed consent


    I have read the Client Informed Consent above and agree to it.


    Miriam will send you a payment link after this contract is processed. Please don't include any card details here.

    Prefer to print and sign by hand? Download the rental agreement as a PDF and email it to miriam@wholefamilyneurofeedback.com.

    Questions before you commit? Call 303-222-5118 or email miriam@wholefamilyneurofeedback.com — we're happy to talk it through first.