Assumption of Risk and Release of Liability/Medical Disclaimer
In order to work together, this document must be signed. This is standard and protects you as well.
I hereby acknowledge and agree:
- The purpose of health coaching is to improve the overall health, vitality and well-being of the body through nutritional education and the use of natural foods, non-medicinal nutritional supplement suggestions, and lifestyle changes. The Certified Nutrition and Macro Coach, Danielle Marenburg, does not diagnose diseases, disorders or conditions.
- The Certified Nutrition and Macro Coach, Danielle Marenburg, is not a licensed Dietitian, Naturopathic Doctor or Medical Physician.
- As part of the Health Coaching Services, I may be asked to provide information concerning my physical habits, medical history, moods, energy levels, likes and dislikes, lifestyle and diet. This information is collected to enable the Certified Nutrition and Macro Coach to: (i) assess my knowledge of nutrition, (ii) education me about the benefits of sound nutritional practices and (iii) recommend dietary changes to improve my general health, vitality and overall
well-being. The Certified Nutrition and Macro Coach, Danielle Marenburg will hold this information in confidence and will not release or disclose this information to any other person, without my prior consent, except as required by applicable law.
- If the Certified Nutrition and Macro Coach, Danielle Marenburg, suspects the existence of disease, disorder or condition, I will be informed of this suspicion. However, I acknowledge this is not a diagnosis or conclusion about the state of my health and that I am directed to promptly consult a licensed Physician or Naturopath about any suspected problems.
- Should I request the Certified Nutrition and Macro Coach, Danielle Marenburg, to recommend dietary changes and/or nutritional supplements to enhance my body’s natural ability to resist and/or overcome a known disease, disorder or condition, it is my responsibility to disclose the nature of the disease, disorder or condition and all other relevant details to the Certified Nutrition and Macro Coach, Danielle Marenburg. If I have not previously consulted a licensed Physician or Naturopath about this disease, disorder or condition, I acknowledge that I am directed to promptly do so. I am not to alter or discontinue treatments prescribed by a licensed Naturopath, Physician or other licensed health professional without consulting the individual who prescribed the treatment.
- In providing Health Coaching Services to me, the Certified Nutrition and Macro Coach, Danielle Marenburg, is relying upon the truth, accuracy and completeness of all information I have provided to her. Any recommendations I follow for changes in diet, including the use of nutritional supplements, are entirely my responsibility.
- Danielle Marenburg is in no way liable for my health or safety.
- In consideration of my participation in the Health Coaching Services, I hereby accept all risk to my health, including injury or death that may result from such participation and I hereby release the Certified Nutrition and Macro Coach, Danielle Marenburg, on my behalf and on behalf of my personal representatives, estate, heirs, next of kin, and assigns from any and all costs, claims, causes of action and damages arising from any and all illness or injury to my person, including my death, that may result from or occur as a result of my participation in the Health Coaching Services, whether caused by negligence or otherwise.
- Due to the service nature of Mindin' My Macros, LLC, there are no refunds offered for the purchase of goods. I agree to not dispute any charges for macro assessments, 1:1 package purchases, or for payment plans. If I ever have a question about payment or billing, I will reach out to Dani or her assistant. If I change credit card or debit card numbers, I will notify Dani 48 hours or more before scheduled payment is due. I agree to pay in full for the level of service that I select, and that upon engagement, I am committing to pay the full amount, even when selecting a payment plan.
- 30 days notice is required for cancellation of services and coaching. Upon cancellation, you will pay your final monthly payment and receive your final month of services. Due to the service nature of Mindin' My Macros, LLC, there are no refunds offered for the purchase of goods and/or services. I agree to not dispute any charges for 1:1 package purchases, or for payment plans. If I ever have a question about payment or billing, I will reach out to Dani or her assistant at [email protected]. If I change credit card or debit card numbers, I will notify Dani 48 hours or more before scheduled payment is due. I agree to pay in full for the level of service that I select, and that upon engagement, I am committing to pay the full amount, even when selecting a payment plan.
- I understand that any therapies I undertake at Mindin' My Macros, LLC are undertaken of my own free will. I accept that the ultimate responsibility for my health care is my own and that Danielle Marenburg and additional support staff at Mindin’ My Macros, LLC is here to support me in this. I understand that my practitioner reserves the right to determine which cases fall outside their scope of practice, in which event an appropriate referral will be recommended. I hereby agree to assume full responsibility for any manner of loss, injury, claim or damage whatsoever, known or unknown, incurred as a result of same and I, my heirs, executors, administrators or assigns for any loss, injury, claim or damage sustained as a result of my attendance and/or participation. I have read the above release and waiver of liability, and fully understand its contents and voluntarily agree to the terms and conditions stated.
Danielle Marenburg is not a physician or psychologist, and the scope of his/her consultation services does not include treatment or diagnosis of specific illnesses or disorders. If I, the client, suspect I may have an ailment or illness that may require medical attention, then it is my responsibility to consult with a licensed physician immediately. Only a licensed physician can prescribe drugs. All supplement suggestions need to be approved by my physician. Nothing discussed during coaching sessions equates to medical advice.
Any mention of drugs in the course of consultation is only for the purpose of providing a complete history of drugs that the client is taking and not for Danielle Marenburg to judge the appropriateness of the medication. Any change in prescription or dosage is a decision the client makes with his or her physician.
Rather than dealing with treatment of disease, Danielle Marenburg focuses on wellness and prevention of illness through the use of non-toxic, natural nutritional therapies to achieve optimal health. Danielle Marenburg primarily educates and motivates clients to assume more personal responsibility for their health by adopting a healthy attitude, lifestyle, and diet.
While people generally experience greater health and wellness as a result of embracing a healthier attitude, lifestyle, and diet, Danielle Marenburg does not promise or guarantee protection from future illness.
I fully release any and all claims and liability from Danielle Marenburg, and I will not under any circumstance pursue legal action against her.
By checking below, I acknowledge that I understand that Danielle Marenburg is a Health Coach and not a physician, and that I should see a doctor if I think I have a medical condition. Danielle Marenburg will not be held liable for failure to diagnose or treat an illness, nor will she/he be liable for failure to prevent future illness.
In addition, I have given Danielle Marenburg a complete and accurate account of any medical conditions that I may have and any medications that I am taking.