INFORMED CONSENT AND DISCLAIMER
Andrea Wool, NTP
Thrive Functional Wellness
Before you choose to use the services of Thrive Functional Wellness, please read the following information FULLY AND CAREFULLY.
GOAL: My basic goal is to encourage my clients to become knowledgeable about and responsible for their own healthy choices about food, fitness and lifestyle, so they can maintain their optimum wellness. Thrive Functional Wellness Coaching is designed to provide holistic alternatives, helping my clients make healthier choices and live healthier lifestyles. Thrive Functional Wellness’s services are not designed to treat any specific disease or medical condition. Working toward the goal of optimum health through healthy diet and exercise, absent other health factors, requires a sincere commitment from you, possible lifestyle changes, and a positive attitude. A wellness coach is trained to evaluate your nutritional needs and make suggestions of dietary change and nutritional supplements. As an unlicensed health care provider, I cannot make a medical diagnoses, and I am not trained to make a medical diagnosis, and no comment or recommendation I make should be construed as being a medical diagnosis. Since every individual is unique, I cannot guarantee any specific result from any of the Thrive Functional Wellness services.
HEALTH CONCERNS: If you suffer from a medical or pathological condition, you need to consult with an appropriate healthcare provider. As a functional wellness coach, I am not a substitute for your physician or other appropriate healthcare provider, and I am not trained nor licensed to diagnose or treat pathological conditions, illnesses, injuries, or diseases.
If you are under the care of another healthcare provider, it is important that you contact your other healthcare providers and alert them that you are participating in Thrive Functional Wellness, and alert them to any foods, supplements, and activities I may suggest to you. It is important you always keep your physician informed of your participation in any of the Thrive Functional Wellness programs.
If you are using medications of any kind, you are required to alert Thrive Functional Wellness to such use, as well as to discuss any potential interactions between medications and supplements with your physician and pharmacist prior to taking any of these supplements.
If you have any physical or emotional reaction to changes I may suggest, discontinue their use immediately, and contact both Thrive Functional Wellness and your physician to ascertain if the reaction is adverse or an indication of the natural course of the body's adjustment to the changes.
COMMUNICATION: Every client is an individual, and it is not possible to determine in advance how your system will react to the foods or supplements I suggest. I may need to adjust your program as we proceed until you determine whether your body can begin to properly accept these foods and supplements. It is your responsibility to do your part by making healthy food choices, following your fitness program, getting plenty of rest, and making healthy lifestyle choices. You must stay in contact with Thrive Functional Wellness so I can know what is happening and we can discuss the best course of action.
You should request your other healthcare providers, if any, to feel free to contact Thrive Functional Wellness for answers to any questions they may have regarding your food and exercise modifications.
LICENSURE. I hold a Nutritional Therapy Practitioner certification from the Nutritional Therapy Association, but I am not a licensed dietitian or nutritionist. Functional Wellness is not licensed or certified by the state of RI. I am providing my functional wellness services as an unlicensed health care practitioner in accordance with R.I. General Laws Section 23-74-14 et al.
PAYMENT: Services provided by Thrive Functional Wellness are not covered by insurance. Payment in the forms of cash or check are accepted. 24 to 48 hour appointment cancellation notice is required, otherwise payment for that service is required.
By my/our signature(s) below, I/we confirm that I/we have read and fully understand the above disclaimer, are in complete agreement thereto and do freely and without duress sign and consent to all terms contained herein.
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