Please provide the information in the form below for the purpose of entering into the Solex AO scanner.

Disclaimer: The scanner is not a medical device. It does not cure, mitigate, or prevent any disease or condition. You are freely providing this information to work with Thought Genius, LLC and Dr. Jeffrey L. Fannin, Ph.D. and constitutes as an agreement and commitment to abide by all instructions, protocols or exercises provided. This is for consulting purposes and any information provided does not fall under HIPAA standards.

Term of service: Typically 90-Days. Periods of longer duration will be handled under a separate  agreement. Term begins from the date of providing information and/or payment for services.

Please be as accurate as possible and convert feet to inches. If measuring in centimeters, please convert to inches.