Terms of Service/Disclaimers/Liability Waiver
Release of Liability for Receipt of Nutrition Information and Waiver of Claims Arising From Receipt of Nutrition Information Disclaimer
The nutrition information provided is designed for and solely intended to be suggestions, which may voluntarily be implemented into the diet of the person whose signature appears below (“the client”). Use of any nutrition information provided is voluntary and each user is solely responsible for their voluntary choice to implement the dietary suggestions. It is the sole responsibility of the client to provide complete and accurate information. Any misinformation or omitted information may affect the nutritional assessment or advice. Any misrepresented information is solely the client’s responsibility and will not be liable.
The Registered Dietitian/Health Coach provides nutrition consulting and recommendations only and is not licensed to diagnose a medical condition or illness. The client must consult a physician for any medical advice.
Acknowledgement of Purchase I, ___________________, through the purchase of Registered Dietitian/Health Coach sessions, have agreed to participate voluntarily in a nutrition program under the guidance of The T Life, its authorized agents, employees, and contractors (“Registered Dietitian/Health Coach”).
Waiver and Release of Liability I have volunteered to participate in a wellness program under the direction of The T Life, which will include but may not be limited to nutritional planning. In consideration of my Registered Dietitian’s/Health Coach’s agreement to assist me, I do here and forever release and discharge and hereby hold harmless the Registered Dietitian/Health Coach and his/ her respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in any nutrition program including any injuries resulting there from.
Assumption of Risk
The T Life recommends you consult your physician before undertaking any diet or exercise program. By implementing the suggestions provided by the Registered Dietitian/Health Coach the client is affirming that she or he has consulted with a medical doctor and has been cleared to implement the suggestions. Any nutrition information provided is not intended to diagnose, treat, cure, or prevent any type of disease or condition. If you need specialized dietary planning to treat, cure, or prevent any type of disease or condition, you should consult with your medical doctor. If I am pregnant or lactating, have high cholesterol, high blood pressure, high blood sugar, diabetes, renal disease, have had gastric bypass surgery, or currently have (or have had in the past) any other medical condition that requires special dietary restrictions, I must receive permission from my physician before participating in the wellness program, or may be advised to seek help from another health professional. I recognize that specific foods may create allergic and possible fatal reactions. I have therefore specified any food allergies/sensitivities I am aware of on the Health History & Lifestyle Questionnaire. I am aware that specific foods may interact with certain medications. I have therefore specified all prescription and OTC medications on Health History & Lifestyle Questionnaire and have discussed the side effects of all my medications with my doctor or pharmacist. I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this wellness program. I understand that results are individual and may vary.
By signing this agreement, I am agreeing to the following terms of The T Life:
• Full Payment is required prior to each session used. Clients will be required to have a card on file to enable The T Life to charge your account if session is not paid beforehand.
• Discounted prices are applicable only if I pay for multiple sessions in full prior to my first appointment using those multiple sessions. I will be charged for a cancelled appointment unless I notify The T Life of cancellation at least 24 hours prior to the scheduled time. If I am late for my appointment, I agree that the lost time will be forfeited, but I will be charged in full for that session.
• I understand that The T Life will try to accommodate preferences for certain appointment times and specific Registered Dietitian/Health Coach requests, but cannot guarantee availability due to other appointments, scheduling conflicts, and other factors.
• I understand that the staff and/or instructor will not be held responsible for any injuries, illnesses, or expenses from my participation, especially if I have neglected to disclose known medical condition or similar information about myself that might affect my ability to participate.
• In signing below, I agree to the above conditions as well as other policies of the facility. I also acknowledge that I have received and understand the Consent and Release form from The T Life.
• If client is a “no show,” after 15 minutes without 24-hour prior verbal or written notice, the client will be charged for that session.
• Registered Dietitian/Health Coach and clients are expected to confirm meeting times so there is no misunderstanding.
• Registered Dietitian/Health Coach sessions expire one year from date of purchase.
Signature Client/individual:_______________________________________________________________________ Printed Name: __________________________________________________________ Date:_____________________