Nature of Services Rendered: The services offered at Mindful heath are counseling in nature and should not in any way be mistaken for medical advice, diagnosis or treatment. Further, supplement, diet and lifestyle recommendations are in no way meant to replace traditional medical care or treatment. Lastly, it is recommended that all participants in Mindful Health’s programs be under the care of a primary care physician.
Not for Medical Purposes: No statements or claims made by Mindful Health, I have been evaluated by the FDA, and no information disseminated by Mindful Health is to be construed as adequate for the purpose of diagnosing, treating or curing disease, nor should it be construed as justification for discontinuing any treatment recommended by a qualified health care professional. In addition, information and/or counseling provided should in no way be considered a substitute for consultation with a licensed health care professional.
Financial Responsibility for all Mindful Health Services: I understand and agree to the following policies regarding financial responsibilities. Payment is required at or before each visit. Services provided at Mindful health are not eligible for reimbursement by my Health Insurance Carrier. I am responsible for all charges incurred for all services rendered or product received from Mindful Health I also agree to be responsible for costs and expenses, including court costs, attorney fees and interest, should it be necessary for Mindful Health to take action to secure payment of an outstanding balance owed.
Please note: By using the Mindful Health Services and registering for this event, you acknowledge that you have read, understood, and agree to be legally bound by the terms and conditions of these Terms of Use and the terms and conditions of our Privacy Policy, which is hereby incorporated by reference (collectively, this "Agreement."). If you do not agree to any of these terms, then please do not use the Services.
Acceptance of Terms of Use.
a. By registering for and/or using the Services in any manner, including but not limited to visiting or browsing the Site, you agree to these Terms of Use and all other operating rules, policies and procedures that may be published from time to time on the Site by us, each of which is incorporated by reference and each of which may be updated from time to time with or without notice to you.
b. Certain of the Services may be subject to additional terms and conditions specified by us from time to time; your use of such Services is subject to those additional terms and conditions, which are incorporated into these Terms of Use by this reference.
c. ARBITRATION NOTICE AND CLASS ACTION WAIVER: EXCEPT FOR CERTAIN TYPES OF DISPUTES DESCRIBED IN THE ARBITRATION SECTION BELOW, YOU AGREE THAT DISPUTES BETWEEN YOU AND US WILL BE RESOLVED BY BINDING, INDIVIDUAL ARBITRATION AND YOU WAIVE YOUR RIGHT TO PARTICIPATE IN A CLASS ACTION LAWSUIT OR CLASS-WIDE ARBITRATION.
You are responsible for notifying Mindful Health of any food allergies or other allergies related to normal food preparation prior to the retreat. By signing this form you agree that Mindful Health, it's representatives, agents, contractors or any corporation, landowner, property, partner or property where the retreats are held shall not be liable or responsible for any food, beverages, or any other products or services offered or provided by the chefs,restaurants, servers or retreat facilitators or any food-borne illness, discomfort, pain,harm or injury incurred by you the user, participant or client.
Due to the highly customized nature of the Mindful Mosaic Personal Retreat service, we are unable to issue refunds or return funds upon cancellation.
Please see additional terms and conditions upon hovering over the signature box above.
Patient Acknowledgment: I certify that the information I provide is correct. I certify that I am here to receive counseling and for no other purpose. I do not represent any third party.
By signing and dating this form I acknowledge I have discussed, or have had the opportunity to discuss, with my counselor the nature and purpose of nutritional counseling in general and my treatment in particular as well as the contents of these Acknowledgements and Authorizations.
I consent to the counseling offered or recommended to me by my counselor. I intend this consent to apply to all my present and future counseling.
Please sign below to indicate you have read, reviewed and understand the aforementioned