Over the next 6 weeks, you will learn ways to help yourself achieve a healthier diet and lifestyle as you participate in The Prediabetes Roadmap™ Coaching Intensive (the SERVICE). Please read the following and ask questions if needed.
I acknowledge that the information and recommendations provided in The Prediabetes Roadmap™ Coaching Intensive are not intended as a substitute for medical diagnosis or advice.
I acknowledge that if I am suffering from conditions requiring medical attention or if I have symptoms that concern me, I should consult a qualified medical practitioner.
I acknowledge that I should not cease conventional treatment or medications for any reason without consulting a doctor.
I understand that I should always discuss any fitness regime, dietary changes or supplements with my doctor or medical provider.
I acknowledge that I take full responsibility for my life and well-being, and all decisions made during and after this program.
I understand that as a part of wellness coaching, I may be coached to or it may be suggested that I participate in fitness activities e.g., exercise, aerobic training, strength training, flexibility training, balance training etc., that could be potentially hazardous. I understand that such activities involve risks of injury and even death, and that I am voluntarily participating in these activities and using equipment and machinery with knowledge of the dangers involved. I agree to expressly assume and accept any and all risks of injury or death. I further understand that there may be risks involved in making dietary changes, such as an increased risk for gallstones, and, for persons with blood sugar issues, fluctuations in blood sugar levels. I acknowledge the risks associated with exercise and physical activity and dietary changes, and willingly assert my desire to participate as herein indicated.
I further acknowledge that I have had either had a physical examination and been given a physician`s permission to participate or that I have decided to participate in activity and or use of equipment and machinery without a physician’s approval and do hereby assume all responsibility and risks of injury or death from such participation and activities.
I understand that the purpose of The Prediabetes Roadmap™ Coaching Intensive is to help me make positive and lasting changes that increase my health and wellbeing. While nutrition and lifestyle support can be an important complement to medical care provided elsewhere, I understand nutrition and lifestyle coaching is not a substitute for the diagnosis, treatment, or care of disease by a medical provider. I do hereby waive, release, and forever discharge The COMPANY and its officers, agents, independent contractors, employees, representatives, executors, and all others from any and all responsibility or liability for injuries or damages resulting from my participation in any activities of wellness coaching, my use of fitness equipment arising out of my participation in any activities under such coaching, or otherwise with respect to the SERVICE.
I understand that my clients have busy schedules and I take pride in respecting that. Each session will end 60 minutes after it was scheduled to begin. Please be on time. If the Client needs to cancel or reschedule the appointment, the Client must do so 24 hours in advance; otherwise, the Client will forfeit that appointment and will not have an opportunity to reschedule it.
As the Client, I recognize that my coaching package expires after 2 months. Two months after my first coaching session, any coaching sessions I have not yet completed are forfeit. This is to ensure that I maximize focus and momentum so I can best prepare myself for lifestyle changes.
The Client understands that the cost of The Prediabetes Roadmap™Coaching Intensive (the SERVICE) is $597. Payment of $597 is due prior to the first coaching appointment.
There are ABSOLUTELY NO REFUNDS of any amount provided. If CLIENT decides to cancel, not participate, or changes his or her mind, the COMPANY DOES NOT PROVIDE ANY REFUND FOR ANY REASON TO THE CLIENT.
The COMPANY reserves the right to cancel the program if at any point the COMPANY feels it is not advantageous for the coaching program to continue. If this happens, the Client is responsible for the pro-rata share of coaching services received with each 60 minute session assigned 1/6 of the full program cost.
The International Consortium for Health & Wellness Coaching defines Health & Wellness Coaching in the following manner: Health and Wellness Coaches partner with clients seeking self-directed, lasting changes, aligned with their values, which promote health and wellness and, thereby, enhance well-being. In the course of their work health and wellness coaches display unconditional positive regard for their clients and a belief in their capacity for change, and honoring that each client is an expert on his or her life, while ensuring that all interactions are respectful and non-judgmental.
My responsibility as health & wellness coach is to guide, educate, and cheer you on in your experience of discovering your best health. Within my scope of practice, I will help you leverage your strengths and values, foster self-acceptance and self-confidence, and assist you with challenges, setbacks, baby steps, and discoveries on your journey to better health. Your responsibilities as a client include bringing awareness and openness to new experiences, choices and habits; taking control of your own physical, mental and emotional well-being, as well as decisions, choices and actions; realizing positive change takes time and dedication to become a habit; and most importantly, understanding that honesty and open communication is an absolute necessity for our coaching relationship to flourish.
As The Client, I am aware that the coaching relationship is in no way to be construed as psychological counseling or psychotherapy and that, in the event that I feel the need for professional counseling or therapy, it is my responsibility to seek a licensed professional.
As The Client, I understand that coaching results are not guaranteed. I am entering into coaching with the understanding that I am responsible for creating my own results.
The key to an effective coaching relationship is communication. Please be honest with yourself and me throughout the coaching process. You can expect me to be straightforward, constructive and confidential. You can say anything to me, positive or negative; this includes letting me know if something makes you uncomfortable or if you don't want to respond to a question. Please let me know at any time if you have concerns that we haven’t addressed. I am a resource for you to use to your best advantage. I will share concepts or insights, and ask questions that are intended to increase your success in attaining your health goals.
The SERVICE is presented for the purpose of educating CLIENTS on wellness lifestyle, and health risk reduction/disease risk reduction topics. COMPANY does not practice medicine, dispense medical services or medications, diagnose or treat medical conditions. The SERVICES should not be considered complete, nor should they be relied on to suggest a course of medical treatment for a particular individual, which can only be provided by a physician or other qualified medical care provider. The Services should not be used as a substitute for or in place of a visit or call to, consultation with, or the advice of The CLIENT’S physician. The COMPANY expects the CLIENT will consult with the CLIENT’S physician before embarking on a new treatment, diet, or fitness program, including the use of the SERVICES. The CLIENT should never disregard or discontinue following medical advice, delay in seeking it, or modify or discontinue medications because of information, materials, or SERVICES provided by the COMPANY.
COMPANY is providing health and wellness counseling and coaching services in lifestyle areas which may include but are not limited to nutrition, weight loss, exercise, fitness, stress management, sleep hygiene, and/or health risk reduction. Professional health coaching is distinctly different from medical consultation, medical treatment, mental health counseling, psychotherapy or psychoanalysis and does not deal with the diagnosis or treatment of medical or emotional problems. SERVICES are provided by a health and wellness coach with National Board Certified Health and Wellness Coach and Wellcoach Certifications as well as a Registered Dietitian Nutritionist credential whose role is to assist CLIENT to make positive changes to increase CLIENT health and wellbeing.
The Client will not hold the COMPANY responsible for unforeseen technical difficulties including but not limited to internet outages. The COMPANY will make every effort to fix the problem to the mutual satisfaction of the Client and COMPANY.
COMPANY agrees not to disclose, reveal, or make use of any Confidential Information learned of through its transactions with CLIENT during discussions and interactions with CLIENT, or otherwise, without the written consent of CLIENT unless compelled by law.
COMPANY shall keep the Confidential Information of the CLIENT in strictest confidence and shall use its best efforts to safeguard the CLIENT’S Confidential Information and to protect it against disclosure, misuse, espionage, loss, and theft.
CLIENT is aware COMPANY will keep notes of coaching sessions to better serve the CLIENT. These notes may include topics discussed, goals set, and/or possible future topics for discussion. Notes will be stored in a secure location by the COMPANY.
CLIENT will maintain the security of CLIENT’S personal health information by refraining from posting confidential health information in online comments, communities, and groups associated with the COMPANY and/or SERVICE and by refraining from using emails and texts to communicate confidential health information.
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