Cycle with Confidence Terms and Conditions
Terms and conditions and liability waiver for Cycle with Confidence by Clean Living with Carly LLC / Carly Hartwig. Please read and acknowledge all statements before signing.
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Client Information
Client Full Name
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First Name
Last Name
Email Address
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example@example.com
Terms Acknowledgments
I understand that this purchase is non-refundable and includes lifetime access.
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I agree
I understand that access may be revoked if I share the materials without a refund.
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I agree
I understand the purpose of working with an HRHP/Justisse Method and that no diagnosis of diseases, disorders, or conditions is provided.
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I agree
I understand that the practitioner is not a licensed Naturopathic Doctor or Medical Physician, and I may accept or reject recommendations.
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I agree
I consent to provide my health history, habits, lifestyle, and diet for individualized recommendations and referrals.
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I agree
I understand that suspicion of a disease, disorder, or condition is not a diagnosis and that I should consult a licensed physician or naturopath.
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I agree
I confirm that the information I provide is truthful, accurate, and complete.
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I agree
I accept responsibility for any diet and lifestyle changes I choose to make.
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I agree
I agree to the commitments for using the Justisse Method, including the introductory presentation, consistent charting, sending charts/forms in advance, punctuality, and active participation.
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I agree
I understand that Carly Hartwig is not liable for my health or safety, including unintended pregnancies.
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I agree
I understand and accept all risks to health, including injury or death, and release Carly Hartwig and related parties from all claims.
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I agree
I understand that 24 hours' notice is required for appointment cancellation and that late cancellations may be charged in full.
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I agree
I understand that email communication may not be fully private and I consent to relevant emails being added to my client record.
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I agree
I understand that all fees are due upon receipt of invoice.
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I agree
I confirm that I am undertaking these therapies of my own free will, that I am ultimately responsible for my healthcare decisions, and that I have read and voluntarily agree to the terms and conditions.
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I agree
Signature and Date
Signature
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Date
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Month
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Day
Year
Date
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