These next questions give us a window into your daily life. Thanks for answering truthfully - not as you wish it to be. :)

Coaching services are intended to promote general health and wellness. This program will focus on motivation and accountability. Empowered Health will not be providing customized or clinical nutrition advice. We will simply provide general healthy living and nutrition tips as Holistic Health Coaching, it's not intended to replace physician care or medical intervention. All assessments, suggestions and/or consultations are about lifestyle and habits and are based on your input, and are not intended to diagnose, treat or cure any disease or ailment. Empowered Healthwill help you through the program with our many years of practice and experience. You acknowledge and agree to accept all responsibility for reviewing diet and nutrition suggestions with a licensed medical professional before following ANY program. As with any program, there may exist inherent risks which may be relative to your state of health, fitness, awareness, care, and skill to which you conduct yourself. You agree that it is your responsibility to inquire about any recommendations with which you are not familiar, and provide any information which may limit your participation in the program. Results and changes in your general health and wellness may vary depending on medical conditions, medications, and accuracy in following suggested guidelines. As your general health and wellness may change with modifications in diet, nutrition, and lifestyle, physician-prescribed medications may require modification. It is your responsibility to discuss this with your physician. Never reduce or eliminate physician prescribed medications without the direction of your physician or medical care provider. Your personal and health information will remain confidential and will not be shared without your consent. Empowered Health reserves the right to refuse services to any individual or refer at any time to appropriate medical professionals. Acknowledgement & Consent to Receive Services. I have read and understand the above disclosure about the services offered by Empowered Health. I have discussed with Empowered Health the nature of the services to be provided. I understand that Empowered Health is not a licensed physician and that coaching services are not licensed by the state, medically authorized, nor sponsored by any licensing bodies. I understand it is my responsibility to maintain a relationship for myself/my child with a medical doctor or licensed health provider. I have consented to use the services offered by Empowered Health and agree to be personally responsible for the fees in connection with the services provided to me. By signing below, you agree to the above terms and conditions for participation with Empowered Health