I hereby acknowledge and agree:
The purpose of Nutritional Coaching Services 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. Paola Xhuli International (including the Holistic Nutritionist, Paola Xhuli and her team) does not diagnose diseases, disorders or conditions.
The Holistic Nutritionist, Paola Xhuli, is not a licensed Dietitian, Naturopathic Doctor or Medical Physician. She has a Master of Public Health from Drexel University and is a Certified Holistic Nutritionist from American Fitness Professionals & Associates. She is working towards and planning to become licensed in the future.
As part of the Nutritional Coaching 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 Holistic Nutritionist to: (i) assess my knowledge of nutrition, (ii) educate me about the benefits of sound nutritional practices and (iii) recommend dietary changes to improve my general health, vitality and overall well-being. Paola Xhuli International 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.
If the Holistic Nutritionist, Paola Xhuli 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.
Should I request the Holistic Nutritionist, Paola Xhuli, 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 Holistic Nutritionist, Paola Xhuli. 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.
In providing Nutritional Coaching Services to me, the Holistic Nutritionist, Paola Xhuli, 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.
Paola Xhuli is in no way liable for my health or safety.
In consideration of my participation in the Nutritional Coaching Services, I hereby accept all risk to my health, including injury or death that may result from such participation and I hereby release Paola Xhuli International, 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 Nutritional Coaching Services, whether caused by negligence or otherwise.
I understand that any therapies I undertake at Paola Xhuli International are undertaken of my own free will. I accept that the ultimate responsibility for my health care is my own and that Paola Xhuli International 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 NUTRITIONAL COACHING SERVICES.