Waiver

I hereby acknowledge and agree:

1.     The purpose of nutritional counseling is to improve the overall health, vitality, and well-being of the body through nutritional education and nutrition coaching/counseling and the use of food and sometimes nutritional supplements. The Nutrition Coach, Mrs Kat Benson, RDN, CSSD, LD, does not diagnose diseases, disorders or conditions BUT can provide Medical Nutrition Therapy in licensed states.

2.     The Nutrition Coach, Mrs Kat Benson, is a Licensed and Registered Dietitian Nutritionist, she is NOT a Medical Physician.

3. As part of the Nutritional Counseling 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 Nutrition 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 Nutrition Coach, Mrs Kat Benson 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 Nutrition Coach, Mrs Kat Benson, 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 about any suspected problems.

5.     Should I request the Nutrition Coach, Mrs Kat Benson, 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 Nutrition Coach, Mrs Kat Benson. If I have not previously consulted a licensed Physician 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 Physician or other licensed health professional without consulting the individual who prescribed the treatment.

6.     In providing Nutrition Counseling Services to me, the Nutrition Coach, Mrs Kat Benson, 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.     Mrs Kat Benson is in no way liable for my health or safety.

8.     In consideration of my participation in the Nutritional Counseling Services, I hereby accept all risk to my health, including injury or death that may result from such participation and I hereby release the Nutrition Coach, Mrs Kat Benson, 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.

9.     I understand that any therapies I undertake at Unlocked Nutrition and/or IronMVMNT are undertaken of my own free will. I accept that the ultimate responsibility for my health care is my own and that Unlocked Nutrition and/or IronMVMNT 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.

 

I HAVE CAREFULLY READ THIS AGREEMENT AND UNDERSTOOD IT TO BE A FULL AND FINAL RELEASE OF ALL COSTS, CLAIMS, CAUSES OF ACTION AND DAMAGES OF ANY KIND ARISING FROM OR IN CONNECTION WITH THE NUTRITION COUNSELING SERVICES.

Group Coaching

I hereby acknowledge and agree:

The purpose of group nutrition coaching is to support, guide, and strengthen member’s skills to have consistent habits that both promote and support healthy actions.

Coaching calls will typically run with the following layout:

  • Discussing and celebrating member wins from the previous couple weeks
  • Members will also have a chance to share any specific challenges they ran into and get coaching through those
  • Seminar/Focused skill/info piece and application ideas by coach
  • Member questions and coaching for specific application

Confidentiality 

Group participants are expected to maintain group confidentiality – meaning, it is against policy and guidelines to share any information about the other participants outside of the coaching calls without their consent. By signing this document, you agree to keeping member confidentiality.

The mode and frequency of coaching 

Coaching sessions are held 1x/month via Zoom video conferencing. Group coaching sessions last 60 minutes.  

Member Conduct 

1. Aim for progression, NOT perfection. 

2. Let coaches coach. Give support but leave the details to the coaches unless asked. 

3. If you don’t know, ask. 

4. Have fun. 

 

Potential grounds for termination 

Reasons are not excluded to the following, but may include: 

  • Being generally rude. We all have bad days, but bringing the energy down every time can cause unnecessary stress on the group dynamic.

  • Being inappropriate on camera. Remember, calls are recorded.