Request edit access
2020 Private Client Contract and Waiver for Sarah Grajeda Fitness
Please read the below Client Contract and Waiver below and e-sign and date below. Submission of this signifies acceptances of this contract and waiver.
Sarah Grajeda Fitness, LLC Client Contract for Nutrition Services and/or Exercise Programming 1.Coaching Credentials: I fully understand that Sarah Grajeda, dba, Sarah Grajeda Fitness, LLC, is not a registered nutritionist, dietician, medical doctor or practitioner and is not here for medical diagnostic or treatment procedures. Sarah Grajeda holds a current personal training certification and nutrition specialization through NASM (National Academy of Sports Medicine) and a nutrition certification through Precision Nutrition, fully insured, and certified in CPR/AED training through the American Safety and Health Institute. 2. Services and Fees: The services performed by Sarah Grajeda, are at all times restricted to consultation on the subject of lifestyle/nutritional matters intended for the maintenance of the best possible state of health and wellness and do not involve diagnosing, prognosticating or treatment of disease. Per this contract, the terms of this nutrition and workout plan include a full daily nutrition plan, supplement recommendations, based on client preference. The length of this program is 12 full weeks unless otherwise agreed upon at the cost of $589 to be paid in full via Wave Payment Invoicing Services. No refunds will be made once this contract is accepted and returned with an e-signature and date. 3. Nutrition and Supplement Recommendations: I fully understand that if there are any supplement suggestions it is my (the client’s) responsibility to check with my (the client’s) MD/ Pharmacist to make sure the suggestions are suitable and that there are no contradictions with any prescription drugs that I (the client) may be taking. Any lifestyle/nutritional suggestions made by Sarah Grajeda are to support and not replace, any medical treatment that you may be receiving. 4.Client Expectations: I fully understand that Sarah Grajeda is a supportive coach, and I (the client) must do my part in changing my lifestyle habits such as: limiting my stress, exercising daily, eating healthier, etc., to see results. I understand that changing my lifestyle takes time and results don’t occur overnight. Average weight loss is typically 0.5-2 pounds per week and 1-2 total combined body inches. Failure to follow the directed nutritional plan and workout will cause failure in achieving desired goals and results. Inconsistent adherence to the plan will result in inconsistent results. I understand that all food and drink must be logged into MFP or MyMacros daily for the length of this program and contract in order for Sarah Grajeda to assist in nutritional advice and help. I understand that the weekly check-in form must be submitted by the deadline of Friday 12pm PST to receive a comprehensive response within 24 hours, and the upcoming week’s nutrition and workout plan changes (if any are needed). Client nutrition and/or training programming is subject to change as needed, and typically does not change on a weekly basis. Clients compliancy dictates changes to programming. 5. Communication Policies: You have a Google Drive where your weekly check in copy is kept. The information you share in your check in will be used to create the upcoming week’s plan if the check-in is submitted by the deadline (see above). Any short issues or questions can be texted to Sarah Grajeda and will be answered at Sarah Grajeda’s earliest convenience. Longer, or more involved issues, should be sent via email to sarahgrajedafitness@gmail.com and will be answered within 24 hours. If a phone call is needed, please text to schedule a time. 6. Privacy: Client information and records are confidential unless Sarah Grajeda receives your advance permission to disclose or except as required by law. All of our conversations and information exchanged is confidential under HIPAA code. 7. Disclaimer: By signing below, I acknowledge that any nutritional/lifestyle/supplement suggestions made by Sarah Grajeda are just merely suggestions, and are not intended as the diagnosis, cure or treatment for any disease or ailment. I also acknowledge that my physician is my primary health care provider and is responsible for supervising all changes in lifestyle habits, diet, exercise and nutrient intake that I make. Any suggestions given are not intended to replace advice from my health care practitioner. I should always consult with a qualified health care practitioner before starting any exercise, diet, health coaching, or nutritional/supplementation program, especially if pregnant, nursing, under 18 years of age, have existing health concerns, or are taking prescription medications. Never disregard medical advice or delay seeking it because of any information given by Sarah Grajeda. I recognize that any activity in which exercise and nutrition bears some risk, which I agree to accept in its entirety. I agree to hold harmless and indemnify Sarah Grajeda, dba Sarah Grajeda Fitness, LLC, from any liability whatsoever resulting from my participation in coaching activities, including but not limited to medical expenses. I accept the risk of any decision, action or outcome based on the coaching relationship. I acknowledge that expectations and results or participation in nutrition and exercise coaching vary among individuals and that each individual may not receive the same benefit. I agree that Sarah Grajeda may discontinue services to me upon notification to me in writing, including email, for any reason, including the following: my failure to cooperate to the best of my ability to the prescribed nutrition and exercise plan, failure to submit weekly check- ins, and lack of professionalism and/or coachability. *
First and last name (signature) *
Your answer
Date *
MM
/
DD
/
YYYY
Email Address *
Your answer
A copy of your responses will be emailed to the address you provided
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy