Environmental Toxin Consulting Package Terms & Conditions
The Environmental Toxin Consulting Package Terms & Conditions (“T&C”) is made between Dirty Girl d/b/a Environmental Toxin Consulting Package and the undersigned individual (“You”). Environmental Toxin Consulting Package and You each acknowledge and agree to and accept the following terms and conditions:
In order to best serve You, the Client Acceptance Policy should be carefully reviewed. It is Environmental Toxin Consulting Package’s opinion that You should be well informed on our expectations and clinical procedures. To prevent any misunderstandings or confusion on what to expect, Environmental Toxin Consulting Package would appreciate that You read the below steps and provide Your signature.
This will attest to the fact that You understand what is expected of You, from working with the Environmental Toxin Consulting Package:
1. Program Participation and Services: By signing this Agreement, You will become a member of the Environmental Toxin Consulting Package (“Package”) wherein Environmental Toxin Consulting Package will provide You with one US Biotek Environmental Pollutants Program, and a 30 minute call to review Your lab test results and a supplement plan (supplements not included) based on Your lab results, symptoms and health goals.
Authorization of health coaching/consulting. Upon signing this agreement, I hereby authorize health, mindset, lifestyle, and nutritional consultations for myself or my minor child by the Environmental Toxin Consulting Package. You agree You are seeking the health coaching and consultation services of Environmental Toxin Consulting Package, employees and staff.
You understand that Environmental Toxin Consulting Package uses some recommendations that may be considered holistic, complementary or alternative. Some of these methods have not been accepted by mainstream medicine. You 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 Environmental Toxin Consulting Package are based on scientific evidence. In no way is Environmental Toxin Consulting Package asserting or implying to holding themselves out to be a Medical Doctor (MD) or 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. You agree and fully understand that the advice and recommendations that are provided by Environmental Toxin Consulting Package are not to be considered medical advice and are for informational and educational purposes only.
Participation: You agree You are solely responsible for creating and implementing Your own physical, mental and emotional well-being, decisions, choices, actions and results arising out of or resulting from the coaching relationship and Your coaching calls and interactions with Environmental Toxin Consulting Package and their staff. As such, You agree that Environmental Toxin Consulting Package or their staff is not and will not be liable or responsible for any actions or inaction, or for any direct or indirect result of any services provided by Environmental Toxin Consulting Package programs. You understand health coaching is not therapy and does not substitute for therapy if needed, and does not prevent, cure, or treat any medical or mental disorder or disease. You understand that successful coaching requires a cooperative and jointly-active approach between Client and Coach. In the coaching relationship, the Coach assists or facilitates awareness and accountability regarding Your changes, but it is Your responsibility to enact change.
Confidential Information: This coaching relationship, as well as all information (documented or verbal) that You share with Environmental Toxin Consulting Package or their staff, as part of this relationship, is bound by the principles of confidentiality set forth in the International Coaching Federation (ICF) Code of Ethics. However, please be aware that the Coach-Client relationship is not considered a legally confidential relationship (like the medical and legal professions) and thus communications are not subject to the protection of any legally recognized privilege including but not limited to HIPAA. Environmental Toxin Consulting Package and their staff agree not to disclose any information pertaining to You without Your written consent. Environmental Toxin Consulting Package and their staff will not disclose Your name as a reference without Your consent. Confidential Information does not include information that: (a) was in Environmental Toxin Consulting Package possession prior to its being furnished by You; (b) is generally known to the public or in Your professional industry; (c) is obtained by Environmental Toxin Consulting Package or their team from a third party, without breach of any obligation to You; (d) is independently developed by Environmental Toxin Consulting Package or their staff without use of or reference to Your confidential information; or (e) Environmental Toxin Consulting Package is required by statute, lawfully issued subpoena, or by court order to disclose; (f) is disclosed to Environmental Toxin Consulting Package or their staff and as a result of such disclosure Environmental Toxin Consulting Package reasonably believes there to be an imminent or likely risk of danger or harm to You or others; and (g) involves illegal activity. You also acknowledge Your continuing obligation to raise any confidentiality questions or concerns with Environmental Toxin Consulting Package or their team in a timely Manner.
Health questionnaire(s). Environmental Toxin Consulting Package may supply an electronic health questionnaire(s) to You. Questionnaires are developed to gather important information about Your previous and current health concerns, lifestyle, eating habits and mindset. You agree completing a health questionnaire is completely voluntary and will help the Environmental Toxin Consulting Package better assist You. Health questionnaires provide information for Environmental Toxin Consulting Package to correctly pinpoint the most probable lifestyle, environment and mindset explanations related to Your health symptoms. However, Environmental Toxin Consulting Package is in no way diagnosing, treating, or acting as a medical professional.
Laboratory testing. Environmental Toxin Consulting Package will not be ordering any insurance covered services, or filing to Your insurance. No ICD-10 or ICD-11 codes will be supplied, as they are in no way diagnosing or treating. Functional lab testing may be included in Your program to help identify environmental and nutritional influences on Your health. You will be presented with detailed information on the specific tests performed and recommended. It is Your responsibility to ensure all lab tests are submitted within the same timeframe so that You can maximize Your time with Environmental Toxin Consulting Package. The results of Your lab tests usually take one to three weeks, sometimes longer depending on lab staffing and supply chain delays. You will be presented with a copy detailing the results of Your labs either from Environmental Toxin Consulting Package or from the lab company. You agree and understand Your responsibility to pay includes fees for laboratory and/or other clinical diagnostic testing and/or services outside of the contract as explained at the beginning of section 1 above. Environmental Toxin Consulting Package is not responsible for lab draw fees in the United States or for shipping costs or lab draw fees outside of the United States.
Nutritional Supplements. You understand that Environmental Toxin Consulting Package makes 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. You are in no way obligated to purchase these products from Environmental Toxin Consulting Package. You are free to purchase any recommended supplements or other products from any source that You choose. You further understand that the Environmental Toxin Consulting Package makes no statement expressed or implied about any product recommended that it is intended to diagnose to treat any disease. No statements made by Environmental Toxin Consulting Package are evaluated by the FDA.
Correspondence. Note that any correspondence via text, email, phone, video, video conferencing, Zoom, or social media is not HIPAA or medically secure, and You share information on these platforms willingly.
Appointments/Visits. You are responsible for attending a call with Environmental Toxin Consulting Package (or someone on their team) to review Your lab test results. Once Your test is finished processing, You will receive an email with an invitation to book a call. After You have booked Your lab review call, it is Your responsibility to keep track of the call details and Zoom link. If You can not locate this information, email email@example.com. Emails will be sent out as a courtesy to remind You of Your appointment, however it is not expected Environmental Toxin Consulting Package will remind You to reschedule if You miss Your appointment. You will not receive added time onto Your agreed upon enrollment with Environmental Toxin Consulting Package if You miss Your lab review call. Environmental Toxin Consulting Package time is valuable, and as such, a rebooking fee of $175 will be charged if You miss Your appointment without at least 24 hours notice to Environmental Toxin Consulting Package. You can email firstname.lastname@example.org to notify of a last-minute 24-hour cancellation.
2. Disclaimer. Environmental Toxin Consulting Package’s Lifestyle, Habit Change and Coaching services are provided solely for Your personal use. The information provided by Environmental Toxin Consulting Package on a phone or video appointment and the information contained in their website or provided through their blog, social media, programs, services or products is not intended to be a substitute for professional medical advice, diagnosis or treatment that can be provided by Your physician, therapist, licensed dietitian, or any other health care professional. Environmental Toxin Consulting Package is not providing health care or medical therapy or mental health services, or attempting to diagnose, treat or cure in any manner whatsoever any disease, condition or other physical or mental ailment of the human body. Rather, Environmental Toxin Consulting Package is serving as a coach, mentor and guide to help You reach Your own health and wellness goals through implementing incremental, positive, healthy, sustainable lifestyle changes that help You live and thrive using simple methods. Sometimes medications are recommended that are approved by the FDA to treat health conditions; Environmental Toxin Consulting Package will not and cannot prescribe any medications due to the nature of this relationship being that of health coaching only. Environmental Toxin Consulting Package is not a covered entity and not participating in an insurance-based plan, nor is Environmental Toxin Consulting Package collaborating with Your medical doctor or other licensed practitioner. As such, You acknowledge HIPAA does not apply in this coach/client relationship.
3. Consult Your Physician or Health Care Provider. Environmental Toxin Consulting Package’s intent is NOT to replace any relationship that exists, or should exist, between You and a medical doctor or other health care professional. Always seek the advice of Your physician or other qualified healthcare professional regarding any questions or concerns You have about Your specific health situation, possible or actual pregnancy, known or suspected food sensitivities or allergies, dietary restrictions, or any medications You are currently taking. Environmental Toxin Consulting Package advises You to speak with Your own physician before implementing any suggestions from their Program, personal coaching sessions, website, blog, e-mails, programs, services and/or products, including but not limited to: before taking any nutritional, herbal, ayurvedic or homeopathic supplement; engaging in an elimination diet, detox or cleanse; performing deep breathing exercises; or participating in any other aspect of a food, diet, exercise or lifestyle program. Do not disregard professional medical advice or delay seeking professional advice because of information You have received from Environmental Toxin Consulting Package. Do not stop taking any medications without speaking to Your physician or health care professional. If You have or suspect that You have a medical problem, contact Your healthcare provider promptly. The information contained on Dirty Girl Detox’s website or provided through their blog, e-mails, programs, services, coaching sessions and/or products has not been evaluated by the Food and Drug Administration and is not intended to diagnose, treat, cure, or prevent any disease, or to be considered medical or psychological advice.
Health coaching and consulting services are exclusively virtual-based and are not affiliated with a hospital or clinic. If You become so ill that You require hospitalization, it is vital that You have a primary care physician with hospital admitting privileges familiar with Your health problems and
history. You understand that in addition to a primary care physician, it may be in Your best interest to have appropriate specialists: for example a cardiologist if You have cardiac problems, or a pediatrician if You are seeking treatment for Your children. If You have not had a physical examination within the last year or since the start of Your most recent health problem, it is highly recommended to schedule an appointment with Your primary physician within a reasonable time after starting with the consultation process, as Environmental Toxin Consulting Package will not be doing any physical examination or seeing You in person. Other tests such as ultrasounds, scans, xrays or traditional laboratory testing would also be completed outside of Environmental Toxin Consulting Package contract with You, as they do not order or prescribe any such testings in their programs.
Environmental Toxin Consulting Package is giving health recommendations only, and although people you interact with may have either a medical degree, registered dietitian or nurse practitioner degree, they are not acting upon their medical professional degree / license in this manner during this
4. Notice to Medicare patients. Environmental Toxin Consulting Package has opted entirely out of the Medicare program, which means that Medicare will not cover any services or procedures performed with Environmental Toxin Consulting Package. You understand that You will not be able to submit any claims to Medicare. You understand that Medicare will not be reviewing any claims, and that an opinion by Medicare that a service is not medically necessary in their view of care would not discharge Your responsibility for payment of said service(s).
5. Insurance claim management. Environmental Toxin Consulting Package does not participate nor is contracted with any insurance company. Environmental Toxin Consulting Package will not provide a receipt and an encounter form to submit to insurance, and does not prepare or submit insurance claim forms. Environmental Toxin Consulting Package is not obligated to respond to insurance carrier requests for
information, and is not obligated to take action on Your behalf against an insurance carrier for collecting or negotiating any claim. You agree You are responsible for the payment of services provided by Environmental Toxin Consulting Package at the time of service without regard to insurance coverage. You are entitled to know the cost of all services and procedures in advance and You will ask if they are not told to You.
6. Refunds and Cancellation. There are no refunds for this Program. You are permitted to cancel Your participation in the Program at any time by providing written notice of cancellation to email@example.com. Environmental Toxin Consulting Package shall have no further obligations to perform under this Agreement following cancellation.
7. Environmental Toxin Consulting Package Does Not Guarantee Results. Environmental Toxin Consulting Package is convinced You will derive great benefits from Your participation in the Program and Environmental Toxin Consulting Package is dedicated to helping You become as successful as You envision. However, Environmental Toxin Consulting Package does not guarantee or represent in any way that You or Your health will attain a certain level or metric of success, either in the short-term or long-term. Your health success depends on many factors, including but not limited to Your personal motivation, Your time commitment, how effectively You implement the strategies taught in the Program, Your efficiency in following up on each coaching strategy. Your participation in the Program is an investment in You and Your health, and, as with most investments, there is potential for a great return on Your investment and risk there will be no return on Your investment. None of the stories shared or examples used in Environmental Toxin Consulting Package’s materials, on the website, or during the calls or events is a guarantee of any particular result or success. Environmental Toxin Consulting Package disclaims any express or implied promise or representation other than those contained in this Agreement.
8. No Transfer of Intellectual Property. You agree and accept that Environmental Toxin Consulting Package’s methods, processes, and strategies taught during the Program services are the sole and exclusive property of Environmental Toxin Consulting Package. Environmental Toxin Consulting Package’s Program includes all materials associated with the coaching services and health strategies she teaches, and all associated coaching advice. You agree and accept to maintain the confidential nature of the Program services and its related materials, strategies, and advice, and You agree not to duplicate, disseminate, distribute, or otherwise disclose any part for any reason to third parties unless such disclosure (i) is part of the services, (ii) is required by valid legal process (whereby You agree and accept to provide prompt written notice of such legal process to Environmental Toxin Consulting Package so that they can take appropriate legal action to protect their interests), or (iii) concerns matters or materials that have lawfully become part of the public domain. You further agree and accept that any violation of the terms of this Section will cause substantial and irreparable harm to Environmental Toxin Consulting Package and that Environmental Toxin Consulting Package is entitled to seek any form of legal redress available, which may include injunctive relief and substantial damages.
9. Termination from Program. You agree and accept that Environmental Toxin Consulting Package may terminate You from the Program by providing You with written notice of termination if Environmental Toxin Consulting Package determines in their discretion that You are conducting Yourself in a manner that is disparaging or disruptive such as defamation or slander to Environmental Toxin Consulting Package , that infringes upon Environmental Toxin Consulting Package, Environmental Toxin Consulting Package’s intellectual property or other rights, or that violates the confidentiality provisions set forth in Section 8. Termination under this Section 9 does not constitute cancellation, and all payments shall immediately become due and payable upon termination.
10. Use of Likeness. You agree and accept that when You are participating in live or online events/programs or group visits, Environmental Toxin Consulting Package is authorized to record, photograph, or otherwise capture Your likeness, voice, images, interviews, and statements made in connection with her programs for Environmental Toxin Consulting Package’s own use. Private coaching sessions are confidential and never recorded unless previously agreed by You. You hereby assign to Environmental Toxin Consulting Package all rights, title, and interest to have and to use, royalty free, any such likeness or portion of Your participation in her live or online events/programs/group visits for advertising, marketing, documentary, informational, training, or any other lawful purpose.
11.Liability: Except as expressly provided in this agreement, Environmental Toxin Consulting Package and her staff make no guarantees, representations or warranties of any kind or nature, express or implied with respect to the coaching services negotiated, agreed upon and rendered. In no event shall Environmental Toxin Consulting Package or their staff be liable to You for any indirect, consequential or special damages. Notwithstanding any damages that You may incur, Environmental Toxin Consulting Package entire liability under this agreement, and Your exclusive remedy, shall be limited to the amount actually paid by You to Environmental Toxin Consulting Package under this agreement for all coaching services rendered through and including the termination date.
12: Indemnification: You shall defend, indemnify, and hold harmless Environmental Toxin Consulting Package, Environmental Toxin Consulting Package officers, employers, employees, staff, contractors, directors, related entities, trustees, affiliates, and successors from and against any and all liabilities and expense whatsoever – including without limitation, claims, damages, judgments, awards, settlements, investigations, costs, attorneys fees, and disbursements – which any of them may incur or become obligated to pay arising out of or resulting from the offering for sale, the sale, and/or use of the product(s), excluding, however, any such expenses and liabilities which may result from a breach of this agreement or sole negligence or willful misconduct by Environmental Toxin Consulting Package, or any of their shareholders, trustees, affiliates or successors. You shall defend Environmental Toxin Consulting Package in any legal actions, regulatory actions, or the like arising from or related to this agreement. You recognize and agree that all of Environmental Toxin Consulting Package shareholders, trustees, affiliates and successors shall not be held personally responsible or liable for any actions or representations of Environmental Toxin Consulting Package or her staff. In consideration of and as part of
Your payment for the right to participate in Environmental Toxin Consulting Package services or programs, the undersigned, Your heirs, executors, administrators, successors and assigns do hereby release, waive, acquit, discharge, indemnify, defend, hold harmless and forever discharge Environmental Toxin Consulting Package and her subsidiaries, principals, directors, employees, agents, heirs, executors, administrators, successors, and assigns and any of the training instructors, guides, staff or students taking part in the training in any way as well as the venue where the programs are being held (if applicable) and any of its owners, executives, agents, or staff (hereinafter “releases”) of and from all actions, causes of action, contracts, claims, suits, costs, demands and damages of whatever nature or kind in law or in a equity arising from Your participation in the services or programs.
13. Arbitration Agreement. Environmental Toxin Consulting Package and You each agree and accept that any dispute arising out of or related to this Agreement or the Program shall be submitted to binding arbitration and heard by a single arbitrator. Arbitration shall be conducted on an individual basis and not on a class, representative, or consolidated basis. By agreeing to binding arbitration, Environmental Toxin Consulting Package and You are each giving up the right to have any claims against the other that already exists or may exist in the future considered by a court or a jury.
The arbitrator shall be provided by JAMS, which makes its rules and terms of arbitration available at www.jamsadr.com, and shall be selected by mutual agreement. Either Environmental Toxin Consulting Package or You may initiate arbitration by giving written notice of arbitration to the other and filing a demand for arbitration with JAMS. If an arbitrator is not selected within 30 days of the date the demand for arbitration is filed, then JAMS is authorized to select a neutral and independent arbitrator, whose decision shall be final and conclusive. The arbitrator is authorized
to issue any form of relief authorized by applicable law, including injunctive relief, declaratory relief, and damages. The prevailing party in any dispute shall be entitled to recover all costs and attorney’s fees incurred in connection with arbitration (including any costs and attorney’s fees
incurred in court seeking to compel arbitration) to the fullest extent allowed by law. The arbitration shall be conducted in Boston, Massachusetts, unless otherwise required by law.
14. Entire Agreement. The terms of this Agreement constitute the entire agreement between Environmental Toxin Consulting Package and You and supersede any prior or contemporaneous written, oral, or implied agreement related to the Program. If any portion of this Agreement is unenforceable, such portion shall be severed and the remainder of this Agreement shall be fully enforceable.
15. Governing Law. The construction, interpretation, and application of the terms of this Agreement are governed by the laws of the State of Massachusetts, without regard to its conflict of law rules. By affixing Your signature below, You agree and accept that You have read the foregoing terms and conditions laid out in this Health Coaching and Consulting Agreement. Further, You have sufficient time to consult Your own attorney before signing.