This consent provides L-Nutra Health with your permission to perform treatment and services available to you via your L-Nutra Health Membership.By signing below, you are indicating that (1) you intend that this consent is continuing in nature even after a specific service(s) has/have been made and treatment recommended; and (2) you consent to treatment and services at L-Nutra Health. The consent will remain fully effective until it is revoked in writing. You have the right at any time to discontinue services.
I understand the benefits and risks of enrolling in the L-NutraHealth program, and I agree to the following:
- I will attend all scheduled sessions with my L-Nutra Health Dietitian Coach and quarterly appointments with my healthcare provider.
- I will inform my healthcare provider of any side effects including low and high blood sugar.
- I understand that I am responsible for the full cost of the program, as health insurance does not cover these services/treatments.
- I understand that L-Nutra Health for Diabetes is intended to be a twelve (12)-month program with a minimum commitment of three (3) months.
- I understand that after three (3) months if I wish to cancel the program, I will contact L-Nutra Health’s customer support team.
- I understand that if I have any medical questions about any treatment or service I’m receiving, that I will direct those questions to my healthcare provider.
- I understand that my credit/debit card will automatically be charged monthly for the duration of the program unless I decide to cancel my membership.My monthly shipment of L-Nutra Health FMD will be shipped at the discretion of the L-Nutra Health Dietitian Coach.