Terms and Conditions.
Nutrition Services Liability Waiver and Consent Agreement
This Nutrition Services Liability Waiver and Consent Agreement (“Agreement”) is made between Planted Nutrition (hereinafter referred to as the “Nutritionist”) and the undersigned client (hereinafter referred to as the “Client”).
1. Scope of Services
The Nutritionist agrees to provide the Client with nutrition counseling and lifestyle coaching services (the “Services”) based on the information provided by the Client. The Nutritionist will use their best efforts to provide the most up-to-date, evidence-based information in delivering the Services.
2. Disclaimer and Limitation of Liability
The Client understands that the Nutritionist is not a medical professional and is not licensed to diagnose or treat any medical conditions or diseases. The Services are intended solely for informational purposes and should not replace the advice of a medical professional.
The Nutritionist shall not be held liable for any issues or complications arising from incorrect, incomplete, or omitted information provided by the Client. The Client acknowledges that the results of the Services are individual and may vary.
3. Assumption of Risk and Release of Liability
The Client voluntarily assumes all risks associated with their participation in the Services, including but not limited to allergic reactions to foods or interactions between foods and medications.
The Client hereby releases and discharges the Nutritionist, its employees, agents, successors, and assigns from any and all liability, claims, demands, or causes of action that may arise from the Client’s participation in the Services, including any injuries or damages resulting therefrom.
4. Client’s Representations and Responsibilities
The Client agrees to provide complete and accurate information to the Nutritionist and to discuss any food allergies, sensitivities, medication interactions, and medical conditions with their physician or pharmacist prior to participating in the Services.
If the Client is pregnant, lactating, or has any medical condition requiring special dietary restrictions, the Client is responsible for obtaining written permission from a qualified medical professional before participating in the Services.
5. Consent for Use and Disclosure of Protected Health Information
The Client consents to the Nutritionist’s use and disclosure of the Client’s Protected Health Information for the purposes of providing the Services, billing for the Services, and for the Nutritionist’s general healthcare operations.
For the purposes of this Agreement, “Protected Health Information” means any information, including the Client’s demographic information, that relates to the Client’s past, present, or future physical or mental health or condition, the provision of healthcare to the Client, and that either identifies the Client or from which there is a reasonable basis to believe the information could be used to identify the Client.
The Client understands that they have the right to request restrictions on the use and disclosure of their Protected Health Information, but the Nutritionist is not required to agree to these restrictions. If the Nutritionist agrees to a requested restriction, the restriction is binding on the Nutritionist.