Nutrition Coaching CONTRACT

The following is a contract for the nutrition expertise and coaching of Culinary Nutritionist Nancy Campbell of Nancy Campbell, LLC.

Please review the terms of the contract, and complete the form below to sign.

 

August 16, 2019

The Client agrees:  I hereby employ Nancy Campbell, M.Sc. of Radiant Health / Nancy Campbell, LLC. for the purpose of coaching me with respect to my nutrition and health goals.  I understand and agree that Nancy Campbell is not a licensed medical physician or a registered dietitian and she has not promised, shall not be obligated to and will not:  (1) advise the Client to change or alter his/her medication prescriptions; (2) provide medical advice that would substitute for the advice and medical oversight of the Client’s physician; or (3) act as a therapist, providing psychological counseling, psychoanalysis or behavioral therapy.  I further understand that as a specialized form of consulting, health counseling is not the same as licensed medical treatment; and that I am always free to reject any advice, suggestions or requests made by my coach at any time. In the event that I feel the need for medical treatment or professional counseling or therapy, it is my responsibility to seek a licensed professional. 

FEE PLAN: Three (3) monthly payments of $249. The first payment must be made on or before August 20, 2019.  Subsequent payments must be made by the 20thof September and October.

PAYMENT PROCEDURE: Nancy will invoice the Client via email.  Payment will be made via Venmo to @Nancy-Campbell-1.

REFUND POLICY/LATE FEE: Client must notify Nancy Campbell in writing by midnight, August 22, 2019 in order to cancel the program and receive a full refund.  With cancellation of the program after midnight August 22, 2019, the client’s first payment of $249 will not be refunded and no subsequent payments will be refunded. A late fee of $75 will be charged for payment not received 48-hours after the 3 monthly payment due dates – August 20, 2019, September 20, 2019, and October 20, 2019.

SESSION TIMES: A schedule of initial session dates and times has been agreed upon with the client.  Subsequent sessions will be provided to the client or scheduled with the client.

VIRTUAL SESSION PROCEDURE: Client will be provided with necessary details for sessions using Zoom prior to the start the virtual sessions scheduled.

CONFIDENTIALITY: The Coach will honor the confidentiality of everything discussed with the client.  In addition, the Coach will not divulge that the Coach and Client are in a coaching relationship without the permission of the Client. 

CLIENT AND COACH AGREE TO ABIDE BY THE POLICIES AND PROCEDURES AS LISTED.

Above Agreed to by:

Name - Client 1 *
Name - Client 1
Name - Client 2
Name - Client 2
Address for Billing *
Address for Billing
Agreement Confirmation *
By providing your personal information above, checking the box below, and submitting this form, you agree to the terms of this agreement.