Consultation Agreement Form
When you book an appointment with me, Antoniya Dzhadzheva, a certified holistic nutritionist and founder of Nutritious Plants, you agree to the following:
The nutrition consultations offered by me on this website are intended towards educational purposes only. I do not treat, diagnose or prevent any diseases. As a holistic nutritionist, I follow the scope of practice and code of ethics set by the Canadian School of Natural Nutrition. I can help you balance any nutritional imbalances that may show up on your intake form and guide you on your wellness journey. It's your responsibility to consult your physician if you have any medical conditions that require treatment, as it is to contact your physician for approval of participation in these consultations.
You agree to hold harmless and indemnify Nutritious Plants and its founder Antoniya Dzhadzheva from any liability whatsoever resulting from your participation in nutrition consultations, including but not limited to medical expenses. You accept the risk of any decision, action or outcome based on the consultation relationship. You acknowledge that the results of participation in consultation activities vary among individuals and that each individual may not receive the same benefit. You agree that Antoniya Dzhadzheva, a holistic nutritionist, may discontinue services to you upon notification to you in writing for any reason, including the following: your failure to cooperate to the best of your ability in the activities and planned schedules.
Unless agreed otherwise, our sessions will be run online using the Jitsi platform. You will be provided with a link prior to the appointment, which will enable a video call. No registration is required from your side, only a working internet connection.
If you have questions between sessions, you are welcome to email me. I will do my best to answer as soon as possible.
Fees and payment
You agree to the designated fee at the time of purchase. Payments will be made using Stripe. All payments are made at the time of booking and prior to the scheduled appointment.
Cancellation or rescheduling is possible up to 24 hours prior to your appointment. If you fail to inform me on time, 100% of the fee will be charged.
I authorize Antoniya Dzhadzheva to collect my personal and medical information acquired from the intake form. I also understand that this information is confidential and will only be disclosed to third parties with my permission.
You agree to cooperate in completing questionnaires/food logs/other assessment material on a timely basis so productive consultation can occur. For each initial consultation you will be sent an intake form that you have to fill out and email me back prior to your appointment. This is essential in order for our first session to take place.
I declare that I am at least 18 years of age.
Written by Antoniya Dzhadzheva,
Holistic nutritionist and founder of Nutritious Plants