Waiver & Release of Liability
I understand that my health coaching/nutrition counseling session will be conducted by a licensed and registered dietitian (RD) who is an Independent Contractor (IC) provided to me through Real Dietitian LLC. As such, Real Dietitian LLC is not liable for any of the information provided by the registered dietitian in the health coaching/nutrition counseling session. I understand that the registered dietitian is not an allopathic licensed medical doctor and is not offering me any kind of medical opinion. I fully understand that I am not being diagnosed or treated for any disease. I am not being prescribed any drugs, surgery or any other allopathic intervention. I have selected this service by my free informed choice. I am aware of the registered dietitian’s qualifications and certifications. I understand this registered dietitian will not discourage me from any protocols other doctors have prescribed. I am simply seeking wellness enhancing suggestions that could improve my present health and future wellness. Any recommendations I follow for changes in diet, including but not limited to the use of food supplements are entirely my responsibility.
As a licensed and registered dietitian, the registered dietitian primarily educates and motivates clients to assume more personal responsibility for their health by adopting a healthy attitude, lifestyle, and nutritional regimen. While people generally experience greater health and wellness as a result of embracing a healthier attitude, lifestyle, and diet, Real Dietitian LLC and the registered dietitian do not promise or guarantee weight loss, goal accomplishment, and/or protection from future illness.
I am here for this visit and any subsequent visit solely on my own behalf and not as an agent or informant for any federal, state, local or private agency on a mission or entrapment, investigation or for any other reason that might bring legal charges against the registered dietitian or Real Dietitian LLC.
By signing below, I acknowledge that I understand that the registered dietitian is an independent contractor for Real Dietitian LLC and that I should see a doctor if I think I have a medical condition. Real Dietitian LLC will not be held liable for failure to diagnose or treat an illness, nor will Real Dietitian LLC be liable for failure to prevent future illness. Additionally, I promise to give the registered dietitian and Real Dietitian LLC a complete and accurate account of any medical conditions that I may have and any medications and/or supplements that I am taking.
In consideration of my participation with the registered dietitian provided by Real Dietitian LLC, I hereby accept all risk to my health and of my injury or death that may result from such participation and I hereby release Real Dietitian LLC, its governing board, officers, employees and representatives from any liability to me, my personal representatives, estate, heirs, next of kin, and assigns for any and all claims and causes of action for loss of or damage to my property and for any and all illness or injury to my person, including my death, that may result from or occur during my participation in the nutrition counseling, whether caused by negligence of the registered dietitian or Real Dietitian LLC, employees, or representatives, or otherwise. I further agree to indemnify and hold harmless Real Dietitian LLC and the registered dietitian, officers, employees, and representatives from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in the described nutrition counseling.
- The client must supply accurate contact information (phone and email).
- The client must receive call when registered dietitian calls. The registered dietitian will call a total of three times if client does not pick up first or second attempt.
- If the appointment begins later than the scheduled start time due to client not available at the scheduled start time, the session will end at the scheduled ending time.
- Any cancellations must occur within 48 hours prior to the scheduled time. Failure to do so will result in the client forfeiting the session and being charged half of the total payment due. If the client reschedules within 48 hours, the client may select a new time for the appointment without any penalty. The client is allowed to reschedule without penalty twice, but any furthering rescheduling will result in forfeiting of the full payment.
Registered Dietitian Responsibilities:
- The registered dietitian provides clients with the motivation, education, guidance, and individual instruction necessary to achieve their personal nutritional goals.
- The registered dietitian will contact the client within five minutes of the scheduled appointment time.
- The registered dietitian will call a total of three times if client does not pick up first or second attempt.
I HAVE CAREFULLY READ THIS AGREEMENT AND UNDERSTAND IT TO BE A RELEASE OF ALL CLAIMS AND CAUSES OF ACTION FOR MY INJURY OR DEATH OR DAMAGE TO MY PROPERTY THAT OCCURS WHILE PARTICIPATING IN NUTRITION COUNSELING AND IT OBLIGATES ME TO INDEMNIFY THE PARTIES NAMED FOR ANY LIABILITY FOR INJURY OR DEATH OF ANY PERSON AND DAMAGE TO PROPERTY.