CLIENT AGREEMENT 

In order to best serve you, the Client Acceptance Policy should be carefully reviewed. It is our opinion that you should be well informed on our expectations and recommendations. To prevent any misunderstandings or confusion on what to expect, we would appreciate that you read the below steps and consent to this policy. This will attest to the fact that you have read the Client Acceptance Policy and understand what is expected of you, as well as what to expect from working with us.

GENERAL POLICIES

If I have not had a physical exam within the past year or since the start of my most recent health problem, I understand it is highly recommended to schedule an appointment with my primary care provider within a reasonable time after starting with the consultation process, as my team will not be doing a physical or seeing me in person.

I understand there will be no insurance covered services or filing to my insurance. No ICD-10 codes will be supplied.

Note that any correspondence via text, phone, video, Facebook, Instagram, or any other means during and after my entire relationship with Live Refreshed, LLC is not HIPPA or medically secure, and I share information on these platforms willingly.

Live Refreshed, LLC will do their best to accommodate all scheduling needs. It is my responsibility to reach out and inquire about setting up a time for my appointment, or scheduling if nothing is available on the online calendar provided.

Payment for this package must be paid in full, or in the agreed upon means. No services will be provided prior to payment.

There will be no refunds of payment, for any reason, despite whether or not I complete the full program with Live Refreshed, LLC.

If I am late or miss one of my weekly appointments, this will not be rescheduled unless I notify Live Refreshed, LLC 48 hours in advance.

I am voluntarily requesting services with Live Refreshed, LLC in regards to weight loss therapy as determined by a mutual decision between myself and the consultant.

I acknowledge that the weight loss consultant at Live Refreshed, LLC is not my primary care provider. I do not hold them responsible for treating or diagnosing any health problems. I agree that I will continue with routine care through my primary care.

AUTHORIZATION OF CONSULTATIONS:

I hereby authorize health, lifestyle, mindset, and nutritional, and other such consultations for myself while working with Live Refreshed, LLC.

NOTICE AS TO NATURE OF SERVICES:

I seek the health consultation services of Live Refreshed, LLC. I understand that Live Refreshed, LLC uses some recommendations that may be considered holistic, complementary, or alternative. Some of these methods have not been accepted by mainstream medicine. I understand that the principles of this practice are based on Functional Medicine, a health system, in which we believe that the body has an inherent ability to heal itself given the right tools. Not all treatment modalities provided by Live Refreshed, LLC are based on science-based evidence. In no way is Lauren Gary functioning as a Nurse Practitioner through Live Refreshed, LLC  or any other medical professional in this consulting relationship. Furthermore, the term “patient” may be utilized, and is understood as a customary term and does not imply or expressly constitute a conventional doctor/patient relationship has been established. The term “client” will be most solely used. I fully understand that the advice and recommendations that are provided by Live Refreshed, LLC are not to be considered medical advice and are for informational and educational purposes only.

Some of the recommendations and thoughts that are used by Live Refreshed, LLC include the following:

• A person’s lifestyle including his or her diet, exercise patterns, sleep habits, and stressors are believed to be related to the development and maintenance of illness. Live Refreshed, LLC will evaluate these factors and seek to help the client give up negative lifestyle patterns and establish more positive ones regardless of age or type of medical problem.    
• Although prescription and over-the-counter medications are used when a physician believes it is necessary, an attempt will be made to use products that are naturally familiar to the body. These include but are not limited to, nutritional supplements such as vitamins, minerals, enzymes, amino acids, essential oils, essential fatty acids, and foods.

• Because Live Refreshed, LLC will look for imbalances in the body and for trends that may result in illness if not addressed, tests are sometimes ordered that may be considered by consensus mainstream medicine to be either unnecessary or of no value. These may include tests for nutritional status, such as blood levels of vitamins and minerals, hormone levels, tests for heavy metals, or tests for allergies.

• Live Refreshed, LLC very much believes in a person being involved in their own health care and encourages questions, exploration, and participation in decisions.

• Exercise is extremely important in maintaining health and promoting wellness as well as helping one to recover from an illness. Graded exercise, both aerobic and stretching, is encouraged for most patients. We advise that you consult your primary care physician and complete a comprehensive physical exam before engaging in any such activities.

• Sometimes medications are recommended that are approved by the FDA to treat one condition; however, that same medication may be used for treatment that has not been FDA approved. We will not and cannot prescribe any medications due to the nature of this relationship being that of consultation only.

Weight Loss Policies

I understand that treatments used at Live Refreshed, LLC might not be considered a medical necessity. Treatments rendered are for the purpose of improving my quality of life through nutritional and supplemental counseling and weight loss coaching.

I understand obesity is a chronic condition and there is a risk of regaining the weight I have lost in this program once the program ends. I understand the importance of maintaining a healthy diet and active lifestyle to help maintain a healthy body mass for life.

I acknowledge that the amount of weight loss varies from client to client, and is, to a large extent, dependent on each patient’s personal motivation and commitment to their diet and exercise plan. No claims as to efficacy or specific amount of weight loss is either expressed or implied.

TERMS & SERVICES

As the client, I agree to pay Live Refreshed, LLC a total amount of five thousand five hundred dollars ($5,500). All invoices must be paid in full prior to the start of the program.

The duration of the program will be 6 consecutive months and includes the following:

• High level 1:1 support and accountability with a weight loss consultant
• Individualized coaching sessions (biweekly)
• Individualized personal training sessions
• Group coaching sessions (monthly)
• Individualized meal planning and nutrition coaching
• Regular weekly check ins to track your progress
• Access to educational content via The Natural Weight Loss Academy

NOTICE THAT SERVICES ARE NOT PRIMARY CARE: I understand that no physician or any other practitioner that I see through Live Refreshed, LLC is acting as my primary care physician. As such, emergency services are not offered. I understand that even though my consultants may address issues affecting my general health that it is required to have a primary care physician. This is important because these practices are exclusively virtual-based and are not affiliated with a hospital. If I become so ill that I require hospitalization, it is vital that I have a primary care physician with hospital admitting privileges familiar with my health problems and history. I understand that in addition to a primary care physician, it may be in my best interest to have appropriate specialists, such as a cardiologist if I have cardiac problems or a pediatrician if I am seeking treatment for my children.

NO GUARANTEES: I understand that Live Refreshed, LLC does not make any representations, claims or guarantees that I will be helped with my medical problems or conditions by undergoing consultations with them. However, they will do their best to help me accomplish my health and wellness goals.

REVOCATION OF AUTHORIZATIONS: These authorizations will remain active unless revoked by me in writing at any time. I understand such revocation will not affect my financial responsibility to pay for services rendered.

NUTRITIONAL SUPPLEMENTS: I understand that Live Refreshed, LLC and team members will make nutritional supplements and other recommended products available. Many of these products are not available through retail outlets. These are provided for the convenience of clients. I am in no way obligated to purchase these products from my consultant. I am free to purchase any recommended supplements or other products from any source that I choose. I further understand that my consultant makes no statement expressed or implied about any product recommended that is intended to diagnose or treat any disease. No statements made by Live Refreshed, LLC are evaluated by the FDA.

INSURANCE CLAIM MANAGEMENT: We do not participate nor are contracted with any insurance company. We will not provide a receipt or an encounter form to submit to insurance, and do not prepare or submit insurance claim forms. We are not obligated to respond to insurance carrier requests for information, and are not obligated to take action on my behalf against an insurance carrier for collecting or negotiating my any claim.

I am responsible for the payment of services provided by Live Refreshed, LLC at the time of service without regard to insurance coverage. I am entitled to know the cost of all services and procedures in advance and it is my responsibility to ask if they are not told to me.

FINANCIAL INSURANCE RESPONSIBILITY FOR ALL SERVICES: I understand my responsibility to pay includes fees for laboratory and/or other clinical diagnostic testing and/or services requested by Live Refreshed, LLC. I also agree to be responsible for costs and expenses, including court costs, attorney fees and interest, should it be necessary for Live Refreshed, LLC to take action to secure payment of an outstanding balance owed.

Any and all past due patient balances, if applicable, will be collected before my appointment. In addition to the fee for consultations, the cost for lab work or other specialized testing deemed appropriate to my case will be applied to my balance if necessary.

We are committed to providing the best consultations for clients. All appointments are considered confirmed at the time they are made. I understand all payments must be made prior to appointment time. Because a substantial amount of time has been set- aside for me, I will forfeit any charges for a missed appointment. If an appointment is missed, I am not guaranteed a make-up appointment for that week, it is my responsibility to re-schedule, and my allotted time with Live Refreshed, LLC will not be extended, under any circumstances. If I need to miss appointments due to illness, vacation, travel, or family emergencies, I am not guaranteed additional appointments to make up for that time, and will still be responsible for the cost of that appointment. I understand that I need to make my best attempt to contact my consultant 48 hours in advance if I cannot keep the appointment.

It is clear that there will be no refunds for any services agreed upon by myself and Live Refreshed, LLC. If I pay in full and am unable or unwilling to complete my time with this company, regardless of how much time, if any, we have spent together, I do not receive a refund for my payment. If I am on payment plans, I fully agree and understand that I am responsible to fulfill all monthly payments on the first of each month, and I will not be given any consultations or email access until that payment is complete. If I am on payment plans, I certify that I will complete all months of payment regardless of if I complete my work with my consultants, or discontinue services, and regardless if I miss an appointment, or even entire months with my clinicians regardless of what the reasoning may be. In addition, if I miss an appointment, or multiple appointments due to any reason, I will not be granted additional time onto your package. I am fully aware there are no “pauses” in my program when I sign on as a client, my time with Live Refreshed, LLC is for 3 consecutive months, with no exceptions. If I must miss a month or multiple months, I do not get reimbursed for that payment or time. There are no partial refunds.

CLIENT ACKNOWLEDGEMENT: I certify that I am here to receive consultation services only and/or they are not substitutes for appropriate medical care. I do not represent any third party. I have read, understood and agree to the foregoing. I understand that I have the right to review this consent with an attorney if I choose before accepting any consultation or services. I have executed this consent freely and willingly understand its provisions. I recognize that Live Refreshed, LLC will rely upon my signing of this document in accepting me as a client and establishing me under legal contract.

I acknowledge receipt of a copy of this consent if I have requested it.