Assumption of Risk and Release of Liability
I hereby acknowledge and agree:
1. The purpose of nutritional therapy is to improve the overall health, vitality and well-being of the body through nutritional education and the use of natural foods and non-medicinal nutritional supplements. The Nutritional Therapy Practitioner, Katie Tougas, does not diagnose diseases, disorders or conditions.
2. The Nutritional Therapy Practitioner, Katie Tougas, is not a licensed Dietitian, Naturopathic Doctor or Medical Physician.
3. As part of the Nutritional Therapy 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 Nutritional Therapy Practitioner 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 Nutritional Therapy Practitioner, Katie Tougas 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.
4. If the Nutritional Therapy Practitioner, Katie Tougas, 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.
5. Should I request the Nutritional Therapy Practitioner, Katie Tougas, 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 Nutritional Therapy Practitioner, Katie Tougas. 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.
6. In providing Nutrition Therapy Services to me, the Nutritional Therapy Practitioner, Katie Tougas, 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.
7. Katie Tougas is in no way liable for my health or safety.
8. In consideration of my participation in the Nutritional Therapy Services, I hereby accept all risk to my health, including injury or death that may result from such participation and I hereby release the Nutritional Therapy Practitioner, Katie Tougas, 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 Nutrition Therapy Services, whether caused by negligence or otherwise.
9. 24 hours is required for canceling/rescheduling appointments.
10. Appointments canceled will be allowed to be rescheduled for the month that it was intended for. There can only be 2 check in sessions per month, if you do not reschedule for the intended month you will fore-fit your session, without refund.
11. I understand that any therapies I undertake at SOS Health and Wellness are undertaken of my own free will. I accept that the ultimate responsibility for my health care is my own and that SOS Health and Wellness 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.