I consent to receive nutritional counseling services from Training Loft (the “Practice”) so that I can obtain information and guidance about health factors within my own control (diet, nutrition, and related behaviors) in order to nourish and support my health and wellness. Nutritional evaluation or testing provided in counseling is not intended for the diagnosis of disease. Rather, these assessment tests are intended as a guide to developing an appropriate health-supportive program for me, and to monitor my progress in achieving my goals.
I agree to and understand the following:
1. The purpose of nutritional counseling 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 and does not diagnose diseases, disorders or conditions.
2. The Nutritionist is not a Naturopathic Doctor or Medical Physician.
3. If the Nutritionist 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.
4. Should I request the Nutritionist 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 Nutritionist. 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.
5. In providing Nutrition Services to me, the Nutritionist is relying upon the truth, accuracy and completeness of all information I have provided. Any recommendations I follow for changes in diet, including the use of nutritional supplements, are entirely my responsibility.
6. Nutritionist is in no way liable for my health or safety.
7. In consideration of my participation in the Nutritional Services, I hereby accept all risk to my health, including injury or death that may result from such participation and I hereby release the Nutritionist & Training Loft, 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 Counseling Services, whether caused by negligence or otherwise.
8. I understand that any therapies I undertake at Training Loft are undertaken of my own free will. I accept that the ultimate responsibility for my health care is my own and that Training Loft 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. To ensure the safety and protection of our clients’ health, we are implementing strict protocols that adhere by the latest standards set out by State of California Guidelines.
7312 Melrose Avenue
Los Angeles, CA 90046