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These Terms and Conditions (“Agreement”) are entered into and made effective as of the date of payment (the “Effective Date”) by and between Radiant Health and Wellness, PLLC, a Massachusetts professional limited liability company (“Radiant Health and Wellness”), and the individual receiving Root Cause Clarity Session services and/or their parent or legal guardian if the individual receiving services is a minor (collectively referred to as the “Client”).
By submitting payment, the Client (and, where applicable, the Client’s parent or legal guardian) expressly acknowledges that they have read, understand, and agree to be bound by the terms of this Agreement. If services concern a minor, the parent or legal guardian entering into this Agreement represents that they have the legal authority to consent to services on behalf of the minor.
1.0 Services Included The Root Cause Clarity Session is a focused, individualized holistic and integrative health coaching service designed to help the Client make sense of their health story, recognize relevant patterns and connections, and gain greater clarity regarding areas to focus on or explore from there. The service includes: - One (1) private 60-minute virtual Root Cause Clarity Session; - Individualized discussion of the Client’s health history, symptoms, experiences, previous diagnoses or testing, interventions already explored or tried, and responses to previous interventions, as relevant to the session; - Discussion of patterns, connections, and potential contributing factors identified through the Client’s individual health story; - Guidance regarding areas to focus on, explore, investigate, or discuss with an appropriate healthcare professional when indicated; - and access to a recording of the session when a recording is successfully created and available. The Root Cause Clarity Session is individualized according to the Client’s history, presentation, needs, circumstances, professional scope, and Dr. Harasim’s professional and clinical judgment. Individualized services do not mean that every available service, modality, intervention, test, supplement, or area of health will be discussed or recommended. 1.1 Information Discussed During the Session The Client may be asked to provide information regarding their health history and current concerns before or during the session. Information discussed may include, as relevant: - Current symptoms and health concerns; - Relevant prenatal, birth, childhood, and adult history; - Family history; - Nutrition and digestive health; - Lifestyle, sleep, stress, and nervous-system patterns; - Environmental and other relevant exposures; - Emotional and energetic wellness factors; - Previous diagnoses, laboratory testing, imaging, or other health information; - Medications, supplements, treatments, protocols, dietary changes, and other previous interventions; - and the Client’s responses to previous interventions. The Client is not required to provide a complete medical record or comprehensive collection of laboratory testing for the Root Cause Clarity Session. 1.2 Root Cause Clarity Session The Root Cause Clarity Session is generally provided virtually via Zoom or another appropriate virtual platform. During the session, Dr. Harasim will listen to the Client’s health story, ask questions as appropriate, identify relevant patterns and connections, consider information the Client’s history and previous responses provide, and use professional judgment to help clarify areas that warrant closer attention and where to focus now. Depending upon the Client’s individual circumstances, the discussion may include areas such as nutrition, digestive health, immune function, hormones, nervous-system regulation, lifestyle, environmental factors, emotional or energetic wellness, structural or movement-related factors, previous testing, and other information relevant to the Client’s overall health picture. The Root Cause Clarity Session is intended to provide focused clarity and direction. It does not guarantee identification of a single underlying cause or definitive explanation for the Client’s symptoms or health concerns. 1.3 Scope of the Root Cause Clarity Session The Root Cause Clarity Session does not include: - A comprehensive functional or integrative health consultation; - Comprehensive pre-session review of extensive medical records or laboratory testing; - Detailed interpretation of extensive laboratory testing; - Ordering of laboratory testing; - Development of a comprehensive individualized treatment, supplement, nutrition, or long-term health protocol; - A written personalized health plan; - Ongoing case management; - Unlimited communication or follow-up support; - Physical therapy evaluation or treatment; - Medical diagnosis or medical treatment; - Psychotherapy, psychiatric treatment, or mental-health treatment; - or services otherwise outside the defined scope of the Root Cause Clarity Session. If deeper assessment, detailed laboratory review, testing, treatment planning, physical therapy, ongoing support, or another service appears appropriate, Dr. Harasim may explain the recommendation and why. Any additional service is separate from the Root Cause Clarity Session and is subject to its own availability, scope, fees, and applicable terms. 1.4 Existing Laboratory Testing and Medical Information The Client may discuss relevant laboratory results, imaging, diagnoses, medical information, or previous testing as part of their health story. For example, the Client may share that testing previously identified a particular abnormality or finding and discuss that information in the context of their history and symptoms. The Root Cause Clarity Session does not include a detailed line-by-line review or comprehensive interpretation of extensive laboratory testing or medical records. If additional information, testing, medical evaluation, or a more comprehensive review would be useful, Dr. Harasim may discuss what information could be helpful and why, subject to applicable professional scope and law. Unless expressly stated otherwise in writing, costs associated with laboratory testing, imaging, supplements, medications, medical devices, outside healthcare providers, and other third-party products or services are not included in the Root Cause Clarity Session fee. 1.5 Session Recording The Root Cause Clarity Session may be recorded so the Client can revisit the conversation afterward. Technical failures or other circumstances may occasionally prevent a recording from being created, retained, or delivered. A recording is an ancillary convenience and is not the healthcare record itself. The recording is provided solely for the Client’s personal use and may not be reproduced, distributed, published, sold, shared publicly, or used for commercial, teaching, training, or other unauthorized purposes. 2.0 Nature and Scope of Services The Root Cause Clarity Session is provided as an individualized holistic and integrative health coaching service. Services may include health and wellness education, individualized discussion of the Client’s health history and patterns, discussion of relevant health information, and coaching and recommendations designed to support greater clarity regarding the Client’s health and wellness goals. Dr. Beata Harasim, PT, DPT, FAAOMPT, is a licensed physical therapist in Massachusetts and Connecticut. However, the Root Cause Clarity Session is provided as a health coaching service and is separate from Dr. Harasim’s physical therapy offerings. Purchase of a Root Cause Clarity Session does not constitute enrollment in physical therapy and does not include a physical therapy evaluation, physical therapy diagnosis, physical therapy treatment, manual therapy, hands-on treatment, or other physical therapy services. If physical therapy evaluation or treatment is appropriate, it will be arranged separately and will be subject to the applicable professional requirements, informed consent, documentation, and terms governing those services. Health coaching through the Root Cause Clarity Session may include education and discussion related to areas such as nutrition, digestive health, lifestyle, sleep, stress, nervous-system regulation, mindfulness, emotional and energetic wellness, environmental factors, health habits, general wellness, and other areas relevant to the Client’s individual health picture. The Client understands that health coaching is educational and supportive in nature. It is not medical care and does not constitute medical diagnosis, medical treatment, psychotherapy, psychiatric treatment, or mental-health treatment. Information provided through health coaching is not intended to replace individualized medical advice, diagnosis, treatment, or monitoring from an appropriately licensed healthcare professional. The Client remains responsible for obtaining appropriate medical, mental-health, emergency, and other licensed professional care when needed. 3.0 Payment and Refund Policy The investment for the Root Cause Clarity Session is $148, paid in full at the time of purchase unless a different price or payment arrangement is expressly offered in writing. Payment secures access to the purchased service but does not guarantee any particular health outcome or result. Except where otherwise required by applicable law or where Radiant Health and Wellness cancels the service as described in this Agreement, payments are nonrefundable. If Radiant Health and Wellness determines before the session that the service cannot appropriately be provided, Radiant Health and Wellness may cancel the session and refund amounts paid for services not provided, as appropriate and subject to applicable law. 4.0 Client Responsibilities The Client agrees to provide accurate and complete information to the best of their knowledge and to communicate relevant symptoms, health history, diagnoses, medications, allergies, precautions, reactions, changes, and concerns that may affect the appropriateness or safety of information or recommendations discussed. The Client understands that Dr. Harasim’s guidance and professional judgment are based in part upon the information the Client provides. The Client remains responsible for their healthcare decisions, for deciding whether to implement health and wellness recommendations, and for obtaining appropriate medical, mental-health, emergency, and other licensed professional care when needed. 4.1 Scheduling, Cancellation and Rescheduling The Client is responsible for scheduling and attending the Root Cause Clarity Session according to the scheduling instructions provided following purchase. If the Client needs to cancel or reschedule, at least twenty-four (24) hours’ notice is requested. Each Client is permitted one complimentary reschedule when notice is provided at least twelve (12) hours before the scheduled session. Cancellation or rescheduling requests made less than twelve (12) hours before the scheduled session, as well as missed appointments, may result in forfeiture of the session and/or an additional fee before rescheduling, except where prohibited by applicable law or where Radiant Health and Wellness determines that an exception is appropriate. The Root Cause Clarity Session must be scheduled and used within six (6) months of purchase, unless otherwise agreed in writing. 4.2 Communication The Root Cause Clarity Session does not include ongoing individualized email, text, Messenger, social-media, or other follow-up coaching unless expressly stated otherwise in writing. Communications outside the session are intended primarily for scheduling, administrative, technical, or service-related purposes. Additional individualized assessment, questions requiring new professional review, interpretation of new information, or ongoing health coaching may require a separate appointment or service at Radiant Health and Wellness’s then-current fee. 4.3 Technical Requirements The Client is responsible for maintaining an adequate internet connection, compatible device, and appropriate environment for participating in the virtual session. If technical problems materially interfere with the session, Radiant Health and Wellness will determine an appropriate means of completing or rescheduling the affected portion when reasonably possible. Radiant Health and Wellness is not responsible for internet, device, browser, or other technology problems originating with the Client. 4.4 Email Communication Consent By purchasing the Root Cause Clarity Session, the Client consents to receive communications reasonably related to the service, including purchase confirmation, scheduling information, intake information, session-related resources, payment notices, recording information, and other communications reasonably necessary to administer the service. The Client may separately receive optional educational or marketing communications and may unsubscribe from those communications where applicable. Unsubscribing from optional marketing communications does not prevent Radiant Health and Wellness from sending transactional, scheduling, payment, or other communications necessary to provide the purchased service. 4.5 Emergencies and Urgent Concerns The Root Cause Clarity Session is not an emergency medical or mental-health service. Email, voicemail, text messages, social-media messages, or other communication channels should not be used for emergencies or urgent medical concerns. If the Client believes they are experiencing a medical or psychiatric emergency, the Client should call 911, go to the nearest emergency department, or otherwise seek appropriate emergency assistance. 5.0 Disclaimer The Root Cause Clarity Session is intended to provide holistic and integrative health education, support, individualized discussion, and focused direction within the scope of health coaching services provided by Radiant Health and Wellness. The session is not intended to diagnose, treat, cure, or prevent medical or mental-health conditions and does not constitute medical diagnosis, medical treatment, psychotherapy, psychiatric treatment, or mental-health treatment. The Root Cause Clarity Session does not replace appropriate evaluation, diagnosis, treatment, monitoring, or emergency care from a physician or other appropriately licensed healthcare professional. Participation is voluntary. Radiant Health and Wellness and Dr. Harasim make no guarantees regarding any particular health outcome, identification of a particular root cause, improvement in symptoms, or result from participating in the session or implementing information discussed. Individual responses vary, and testimonials or experiences of other Clients do not guarantee that another Client will experience the same or similar results. 5.1 Affiliate Disclosure Radiant Health and Wellness is a participant in the Amazon Services LLC Associates Program and may participate in other affiliate programs. Some products, educational resources, or recommendations discussed or provided to the Client may contain affiliate links. If the Client purchases through an affiliate link, Radiant Health and Wellness may earn a commission at no additional cost to the Client. The existence of an affiliate relationship does not mean that a particular product is required. 6.0 LIABILITY EXCEPT AS EXPRESSLY PROVIDED IN THIS AGREEMENT, RADIANT HEALTH AND WELLNESS MAKES 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 RADIANT HEALTH AND WELLNESS BE LIABLE TO THE CLIENT FOR ANY INDIRECT, CONSEQUENTIAL OR SPECIAL DAMAGES. NOTWITHSTANDING ANY DAMAGES THAT THE CLIENT MAY INCUR, RADIANT HEALTH AND WELLNESS’S ENTIRE LIABILITY UNDER THIS AGREEMENT, AND THE CLIENT’S EXCLUSIVE REMEDY, SHALL BE LIMITED TO THE AMOUNT ACTUALLY PAID BY THE CLIENT TO RADIANT HEALTH AND WELLNESS UNDER THIS AGREEMENT FOR THE SERVICES GIVING RISE TO THE CLAIM, EXCEPT TO THE EXTENT SUCH LIMITATION IS PROHIBITED BY APPLICABLE LAW. 7.0 INDEMNIFICATION CLIENT SHALL, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, DEFEND, INDEMNIFY, AND HOLD HARMLESS RADIANT HEALTH AND WELLNESS, PLLC, DR. BEATA HARASIM, AND THEIR OFFICERS, EMPLOYEES, CONTRACTORS, DIRECTORS, AGENTS, RELATED ENTITIES, AFFILIATES, SUCCESSORS, AND ASSIGNS FROM AND AGAINST ANY AND ALL LIABILITIES AND EXPENSES WHATSOEVER, INCLUDING WITHOUT LIMITATION CLAIMS, DAMAGES, JUDGMENTS, AWARDS, SETTLEMENTS, INVESTIGATIONS, COSTS, REASONABLE ATTORNEYS’ FEES, AND DISBURSEMENTS, ARISING OUT OF OR RELATING TO THE ROOT CAUSE CLARITY SESSION, THE SERVICES, AND/OR THE CLIENT’S ACCESS TO, PARTICIPATION IN, RECEIPT, IMPLEMENTATION, OR USE OF ANY INFORMATION, RECOMMENDATIONS, RECORDINGS, EDUCATIONAL MATERIALS, PRODUCTS, OR OTHER RESOURCES PROVIDED OR MADE AVAILABLE IN CONNECTION WITH THE SERVICES, EXCEPT TO THE EXTENT SUCH LIABILITIES OR EXPENSES RESULT FROM CONDUCT FOR WHICH LIABILITY CANNOT LAWFULLY BE LIMITED, RELEASED, OR INDEMNIFIED UNDER APPLICABLE LAW. CLIENT AGREES TO DEFEND AND INDEMNIFY RADIANT HEALTH AND WELLNESS, PLLC, DR. BEATA HARASIM, AND THE OTHER PARTIES IDENTIFIED ABOVE IN CONNECTION WITH THIRD-PARTY CLAIMS, LEGAL ACTIONS, REGULATORY ACTIONS, OR OTHER PROCEEDINGS ARISING OUT OF OR RELATING TO THE CLIENT’S BREACH OF THIS AGREEMENT, MISUSE OR UNAUTHORIZED USE OF THE SERVICES OR MATERIALS, OR OTHER CONDUCT BY THE CLIENT FOR WHICH INDEMNIFICATION IS PERMITTED BY APPLICABLE LAW. IN CONSIDERATION OF AND AS PART OF THE CLIENT’S PAYMENT FOR AND PARTICIPATION IN THE ROOT CAUSE CLARITY SESSION AND ANY RELATED RESOURCES PROVIDED OR MADE AVAILABLE IN CONNECTION WITH THE SERVICES, THE CLIENT, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, VOLUNTARILY RELEASES, WAIVES, ACQUITS, DISCHARGES, AND HOLDS HARMLESS RADIANT HEALTH AND WELLNESS, PLLC, DR. BEATA HARASIM, AND THEIR SUBSIDIARIES, PRINCIPALS, DIRECTORS, OFFICERS, EMPLOYEES, CONTRACTORS, AGENTS, AFFILIATES, SUCCESSORS, AND ASSIGNS FROM CLAIMS, CAUSES OF ACTION, SUITS, COSTS, DEMANDS, DAMAGES, OR LIABILITIES ARISING OUT OF OR RELATING TO THE CLIENT’S VOLUNTARY PARTICIPATION IN OR USE OR IMPLEMENTATION OF THE SERVICES, INFORMATION, RECOMMENDATIONS, RECORDINGS, EDUCATIONAL MATERIALS, OR OTHER RESOURCES, EXCEPT TO THE EXTENT SUCH LIABILITY CANNOT LAWFULLY BE WAIVED, RELEASED, LIMITED, OR INDEMNIFIED. NOTHING IN THIS SECTION IS INTENDED TO WAIVE, LIMIT, RELEASE, OR RESTRICT ANY RIGHT, REMEDY, DUTY, OR LIABILITY THAT CANNOT LAWFULLY BE WAIVED, LIMITED, RELEASED, OR RESTRICTED UNDER APPLICABLE LAW. 8.0 Confidentiality and Privacy Radiant Health and Wellness will maintain Client information in accordance with applicable professional, privacy, and healthcare requirements. Client information will not be disclosed except with appropriate authorization or as permitted or required by applicable law. Radiant Health and Wellness will not publicly disclose the Client’s name, health story, testimonial, or other identifying information for promotional purposes without appropriate permission. Virtual communications and electronic platforms carry inherent privacy and security limitations. Clients are encouraged to participate from a private location and use reasonable safeguards for their own devices and communications. 9.0 No Transfer of Intellectual Property Any content or materials provided or made available by Radiant Health and Wellness in connection with the Root Cause Clarity Session, including recordings, written documents, videos, audios, presentations, worksheets, educational content, resources, and other materials (“Intellectual Property”), are copyrighted and are provided to the Client under a single-user license for the Client’s personal use only. The Client may not sell, reproduce, copy, distribute, publish, share, sublicense, modify, create derivative works from, publicly display, publicly perform, teach from, commercially exploit, or otherwise make Radiant Health and Wellness’s Intellectual Property available to another person without written permission. The Client may not share session recordings, access links, downloadable materials, or other protected resources with another individual or entity. All Intellectual Property remains the property of Radiant Health and Wellness and/or its respective rights holders. 10.0 Termination or Cancellation by Radiant Health and Wellness Radiant Health and Wellness may decline, cancel, or terminate the professional relationship when Dr. Harasim determines that providing or continuing the service is no longer appropriate or reasonably feasible. Reasons may include circumstances in which the Client requires services outside the scope offered, another provider or level of care is more appropriate, continuing the professional relationship is no longer professionally appropriate, the Client engages in threatening, abusive, harassing, discriminatory, or otherwise inappropriate behavior, or other circumstances make continuation inappropriate or unsafe. If Radiant Health and Wellness cancels the service before included services have been provided, amounts paid for services not provided will be handled appropriately based upon services already performed and applicable law. 11.0 Insurance and HSA/FSA The Root Cause Clarity Session is a private-pay health coaching service. Radiant Health and Wellness does not bill insurance directly for this service. Because the Root Cause Clarity Session is not being sold or provided as a physical therapy evaluation or treatment service, Radiant Health and Wellness does not represent that it qualifies for physical therapy insurance reimbursement. The Client may be able to use HSA or FSA funds for eligible healthcare services or expenses. Eligibility is determined by applicable law and the Client’s individual HSA/FSA administrator. Radiant Health and Wellness does not guarantee insurance reimbursement or HSA/FSA eligibility. The Client is responsible for verifying eligibility if reimbursement or use of HSA/FSA funds is important to their purchasing decision. 12.0 Services Concerning Minors A parent or legal guardian may purchase a Root Cause Clarity Session to discuss the health history and concerns of an infant, child, or adolescent. When the individual who is the subject of the session is a minor, the parent or legal guardian entering into this Agreement represents that they possess the legal authority necessary to consent to the service on the minor’s behalf. The parent or legal guardian agrees to provide accurate and relevant information regarding the minor and to participate in the session and decision-making as reasonably necessary. Nothing in this Agreement alters rights or obligations established by applicable law. 13.0 Entire Agreement This Agreement reflects the entire agreement between Radiant Health and Wellness and the Client concerning the Root Cause Clarity Session and supersedes prior written or oral representations concerning the terms of this service. The Agreement may not be materially amended except in writing as permitted by applicable law. 14.0 Dispute Resolution If a dispute arises out of or relating to this Agreement that cannot be resolved by mutual consent, the Client and Radiant Health and Wellness agree to attempt to mediate the dispute in good faith for up to thirty (30) days after notice of the dispute is given. If the dispute is not resolved through mediation, either party may initiate legal proceedings. To the extent permitted by applicable law, any legal action arising out of or relating to this Agreement shall be brought in the courts of the Commonwealth of Massachusetts, where Radiant Health and Wellness maintains its principal place of business, and the parties consent to the jurisdiction and venue of those courts. 15.0 Severability If any provision of this Agreement is determined to be invalid or unenforceable, that determination shall not affect the remaining provisions, which will continue in effect to the extent permitted by law. 16.0 Waiver Failure by either party to enforce a provision of this Agreement does not constitute a waiver of that party’s right to subsequently enforce that provision or another provision. 17.0 Applicable Law This Agreement shall be governed by the laws of the Commonwealth of Massachusetts, except to the extent that mandatory laws, healthcare requirements, professional requirements, or consumer protections of another applicable jurisdiction control. 18.0 Binding Effect This Agreement shall be binding upon the parties and their respective permissible successors and assigns to the extent permitted by applicable law. 19.0 Headings Headings are provided for organization and convenience and do not alter the meaning of this Agreement.
I have voluntarily chosen to participate in the Root Cause Clarity Session, which is provided as an individualized holistic and integrative health coaching service by Radiant Health and Wellness, PLLC. I understand that although Dr. Beata Harasim, PT, DPT, FAAOMPT, is a licensed physical therapist in Massachusetts and Connecticut, the Root Cause Clarity Session is separate from her physical therapy services and does not constitute physical therapy evaluation, diagnosis, treatment, manual therapy, hands-on treatment, or other physical therapy services. 1. Description and Scope of Services I understand that the Root Cause Clarity Session may include discussion of my health history, symptoms, nutrition, digestive health, lifestyle, sleep, stress, nervous-system patterns, environmental factors, emotional and energetic wellness, previous testing, diagnoses, medications, supplements, treatments, protocols, and other information relevant to my individual health story. I understand that the session is intended to help identify relevant patterns and connections and provide focused health-coaching guidance regarding areas to focus on, investigate, explore, or discuss with other appropriate healthcare professionals. I understand that the Root Cause Clarity Session does not include comprehensive functional or integrative assessment, detailed interpretation of extensive laboratory testing or medical records, laboratory ordering, a comprehensive individualized treatment or supplement protocol, ongoing case management, medical diagnosis or treatment, psychotherapy, or physical therapy. 2. Voluntary Participation and Client Responsibility I understand that my participation is voluntary and that I may choose whether or not to implement any recommendation discussed during the session. I agree to provide accurate and complete information to the best of my knowledge, including relevant health history, symptoms, diagnoses, medications, supplements, allergies, reactions, precautions, and material changes in my health. I understand that I remain responsible for my own healthcare decisions and for seeking appropriate medical, mental-health, emergency, or other licensed professional care when needed. 3. Potential Risks and Individual Responses I understand that health and wellness information or recommendations may involve changes to nutrition, supplements, lifestyle practices, physical activity, nervous-system practices, or other aspects of health and wellness. I understand that individual responses vary and that implementing recommendations may result in unintended effects, including discomfort, adverse reactions, worsening of symptoms, interactions, or other unexpected responses. I agree to use reasonable judgment when implementing recommendations and to seek appropriate medical attention when necessary. 4. Potential Benefits and No Guarantee of Results The Root Cause Clarity Session is intended to help me gain greater clarity regarding my individual health story, relevant patterns and connections, and areas to focus on or explore next. I understand that individual outcomes vary and that Radiant Health and Wellness and Dr. Harasim do not guarantee identification of a particular root cause, improvement or resolution of symptoms, or any particular health outcome or result. 5. Medical and Mental-Health Care I understand that the Root Cause Clarity Session does not replace appropriate evaluation, diagnosis, treatment, monitoring, or emergency care from a physician, mental-health professional, or other appropriately licensed healthcare professional. I understand that I may be encouraged to seek additional evaluation or care when information arises that is outside the scope of health coaching or would appropriately be addressed by another healthcare professional. 6. Laboratory Testing and Other Health Information I understand that I may discuss relevant existing laboratory results, imaging, diagnoses, medical records, and other health information as part of my health story. I understand that the Root Cause Clarity Session does not include a comprehensive or detailed interpretation of extensive laboratory testing or medical records. Additional laboratory testing, evaluation, supplements, products, or services from other professionals may be discussed when appropriate. Unless expressly stated otherwise, these costs are not included in the session fee. 7. Payment and Participation I understand that the Root Cause Clarity Session requires payment of $148, unless another price is expressly offered to me in writing. I understand that payment and participation do not guarantee any particular health outcome. 8. Assumption of Risk and Release of Liability I understand that participation in health coaching and implementation of health and wellness recommendations involve personal choice and may involve risks or unexpected responses. I voluntarily choose to participate and accept the risks reasonably associated with my participation and implementation of recommendations. To the fullest extent permitted by applicable law, I release and hold harmless Radiant Health and Wellness, PLLC, Dr. Beata Harasim, and their employees, contractors, agents, and associated service providers from claims or liability arising from my voluntary participation in the Root Cause Clarity Session or my implementation of recommendations, except to the extent such liability cannot lawfully be waived or results from conduct for which liability cannot legally be limited or released. Nothing in this Informed Consent is intended to waive rights or remedies that cannot lawfully be waived under applicable law. 9. Acknowledgment and Consent By submitting payment, I acknowledge that: - I have read and understand this Informed Consent, Waiver & Release of Liability and the accompanying Terms and Conditions; - I understand the nature and scope of the Root Cause Clarity Session; - I understand that this service is health coaching and is separate from physical therapy; - I understand that the session does not include comprehensive functional medicine assessment, detailed lab review, medical diagnosis, or treatment; - I have had the opportunity to ask questions before participating; - I understand that no particular health outcome has been promised or guaranteed; - and I voluntarily consent to participate in the Root Cause Clarity Session.
Radiant Health and Wellness, PLLC is committed to maintaining the privacy of your health information. We may disclose your health information to your insurance provider or to other healthcare professionals for purposes of treatment, payment, or healthcare operations. We may disclose your health information to notify or assist in notifying a family member or another person responsible for your care regarding your medical condition, including in the event of an emergency or death. We may disclose your health information as permitted or required by applicable law, including for military, national security, prisoner, government-benefit, public-health, legal, or other authorized purposes. We may communicate with you by telephone, voicemail, text message, email, or other electronic means for purposes including scheduling appointments, providing service-related information, delivering resources, and communicating regarding your consultation. You may have rights regarding your health information, including the right to: - Request restrictions on certain uses and disclosures of your health information, although Radiant Health and Wellness may not be required to agree to a requested restriction; - Request that your health information be received or communicated in an alternative manner or at an alternative location; - Inspect and obtain copies of your health information, subject to applicable law; - Request an amendment to your health information, although Radiant Health and Wellness may not be required to agree to the requested amendment; - and Receive an accounting of certain disclosures of your health information, as provided by applicable law. Radiant Health and Wellness is required to maintain the privacy of protected health information as required by applicable law. Questions or complaints regarding your privacy rights should be directed to: Dr. Beata Harasim, PT, DPT, FAAOMPT Radiant Health and Wellness, PLLC 860-266-7745 Beata@HolisticDrBeata.com Formal complaints regarding applicable federal health-information privacy rights may also be submitted to the U.S. Department of Health and Human Services, Office for Civil Rights. Radiant Health and Wellness will not retaliate against an individual for filing a privacy complaint. By submitting payment and participating in the Comprehensive Integrative Health Consultation, I acknowledge that I have reviewed this Statement of Privacy Notice and authorize and consent to the use and disclosure of my health information as described above, subject to applicable law.
Client Acknowledgment
By submitting payment and enrolling in the Root Cause Clarity Session, I acknowledge that: - I have read and understand the Terms & Conditions, Informed Consent, Waiver & Release of Liability, and Statement of Privacy Notice. - I understand the nature and scope of the Root Cause Clarity Session, including what is and is not included. - I understand that the Root Cause Clarity Session is provided as a health coaching service and is separate from physical therapy evaluation or treatment. - I understand that the session does not include comprehensive functional or integrative assessment, detailed review of extensive laboratory testing or medical records, medical diagnosis, medical treatment, or an individualized long-term treatment protocol. - I understand that no particular root cause, health outcome, improvement, or result has been promised or guaranteed. - If the session concerns a minor, I represent that I have legal authority to consent to services on the minor’s behalf. - I have had the opportunity to ask questions before purchasing and voluntarily consent to participation under these terms. By submitting payment, I acknowledge that I have read, understand, and agree to these Terms & Conditions, Informed Consent, Waiver & Release of Liability, and Statement of Privacy Notice for the Root Cause Clarity Session. Questions may be directed to Beata@HolisticDrBeata.com.
Please e-mail any questions to Dr. Beata at Beata@HolisticDrBeata.com