Before beginning Integrative Nutrition with Next Ingredient, or a Hair Tissue Mineral Analysis, or a Nutrition Assessment Questionnaire, please read the following information carefully, then sign and date.
| NEXT INGREDIENT GOALS |
The fundamental goal of Integrative Nutrition is to encourage people to become knowledgeable about - and responsible for - their own health. A Next Ingredient Nutritionist or Integrative Nutrition Health Coach (INHC) helps individuals reach their optimal level of overall health by supporting and bringing balance to the foundations listed below. All are built upon a single, solid base: properly prepared, nutrient-dense food.
- Metabolic Function
- Blood Sugar Regulation
- Fatty Acid Balance
- Mineral Balance
- Menstrual Cycle Optimization
By supporting each of these foundations and helping clients adopt a more nutrient-dense lifestyle, the body’s chemistry can be brought back into natural balance, setting the stage for optimal health.
Integrative Nutrition is not designed, however, to treat any specific disease or medical condition. An INHC is trained to evaluate your nutritional needs and make recommendations for nutritional change and nutritional supplements, not medical diagnoses or prescription.
Reaching optimal health requires sincere commitment, possible lifestyle changes, and a positive attitude. If you are not willing to change how you eat and live, Next Ingredient is not the right approach for you. Since every human being is unique on a biochemical level, we cannot guarantee any specific results.
| HEALTH CONCERNS |
If you suffer from a medical or pathological condition, you need to consult with an appropriate healthcare provider. An INHC is not a substitute for your family physician or other appropriate healthcare provider. An INHC is not trained nor licensed to diagnose or treat pathological conditions, illnesses, injuries, or diseases, nor prescribe medication.
If you are under the care of a healthcare provider, it is important that you contact your healthcare provider(s) and alert them to your use of nutritional supplements. Integrative Nutrition may be a beneficial adjunct to traditional care, and it may also alter your need for medication, so it is important you continue to work with your physician and keep him/her informed of changes in your nutrition.
If you are using medications of any kind, you are required to alert your INHC to such use, as well as to discuss any potential interactions between medications and nutritional products with your pharmacist. If you have any physical or emotional reaction to Integrative Nutrition, discontinue the protocol immediately and contact your INHC to ascertain if the reaction is adverse or an indication of the natural course of the body’s adjustment to therapy.
| COMMUNICATION |
Every client is a biochemical individual, and it is not possible to determine in advance how your body will react to the nutrients or supplements you need. It is sometimes necessary to adjust your program as we proceed until your body can begin to properly accept targeted nutrients geared to correct imbalances or deficiencies. It is your responsibility to do your part by:
- Following the nutrition guidelines provided by your INHC- Avoiding harmful foods, substances, and behaviors- Moving your body daily- Getting plenty of sleep, rest, and relaxation- Staying in contact with your INHC so they can stay informed of your progress and provide the best course of action going forward
| LICENSURE |
The Institute for Integrative Nutrition (IIN) certifies individuals as “Integrative Nutrition Health Coach" (INHC). Note that a Integrative Nutrition Health Coach does not diagnose or treat disease, but instead makes nutritional recommendations for balancing the body and promote optimal wellness. INHCs are approved by the IIN as a certifying organization, but are not licensed or certified by any state. Please check with your state for specific information on licensing requirements.
During the course of consulting with Next Ingredient, we will ask that you provide relevant personal details and information relating to your background, health, lifestyle, etc. (hereafter referred to as “Information”), including but not limited to:
Your full name, physical address, email address, telephone number, date of birth, etc.Your health history, including injuries, surgeries, prescriptions, etc.
This Information will be gathered from you via in person or online interviews, questionnaires, evaluations, intake documents, phone, email, mail, video conferences, etc, and used to:
- Help assess your nutritional needs- Make recommendations for nutrition changes and nutritional supplements to support your specific nutritional needs and goal- Comply with all legal and INHC training obligations
To ensure the maximum benefit of Integrative Nutrition, it is important that your information is accurate and up-to-date. If you notice any changes to your health, begin taking a new prescription, etc, please notify me as soon as possible.
Though INHCs are not HIPAA regulated entities, Next Ingredient is committed to protecting client privacy and requires its Nutritionists and Health Coaches to uphold the privacy best practices and the policies laid out in the U.S. Standards for Privacy of Individually Identifiable Health Information. We will take all reasonable steps to protect your Information from unauthorized access, use, or disclosure by using strong passwords, up-to-date software on all devices, and locking file cabinets for physical documents. However, even the best security practices cannot guarantee that all stored data will be completely free from third-party interception or corruption.
In accordance with Standards for Privacy of Individually Identifiable Health Information, your consent is required for us to collect, use, and disclose your personal Information. By signing below, you acknowledge your consent for us to collect your Information.
| SIGNATURE REQUIRED |
By signing below, I confirm that I have read and fully understand the above disclaimer, am in complete agreement thereto, and do freely without duress sign and consent to all terms contained herein: