Informed Consent I, ____________________ understand that Angie Leitnaker is a transformational life coach. As such, Angie can not and will not diagnose or claim to cure a disease or prescribe medications. It is myresponsibility to continue any current and/or ongoing medical treatment, therapies, and medications until otherwise advised by my physician, psychotherapist, or medical practitioner.
I understand that I can expect the following:
Transformational Mentorship~empowerment to elevate, enhance & embody personal power and design a life I love!
While working with Angie, I will be presented with information and recommendations for possible lifestyle changes. This may encompass dietary changes, reducing the use of alcohol, caffeine, and artificial sweeteners. Tobacco, recreational drugs and over the counter drugs will also be addressed. The importance of increasing movement and reducing stress will be emphasized. I further understand that any and all lifestyle changes I makeare my choice.
Any information I share it with Angie will be held in the strictest confidence, except when released by me or specifically required by law. I have the right to waive this confidentiality agreement in whole or part at anytime.
I understand that Angie may also consult with the other natural health professionals on her staff. This allows me to receive the benefit of the knowledge and skills of her supporting staff. I give her permission to discuss my plan with these individuals in a confidential manner.
I have read and fully understand the contents of this document. I agree to the terms and conditions stated above. I give my permission for Angie to use my likeness, photo transformations, and testimonials of our worktogether, as a reference for future clients.