Participant Consent – CoreVantage

Participant Notice and Consent

By executing this Participant Notice and Consent, I am voluntarily authorizing the use and disclosure of health and personal information for purposes of my participation in the Program. I have carefully read and understand my rights.

1. I understand that I am voluntarily engaging the CoreVantage Health Coaching services through GemCare Wellness, Inc. (GCW) so that I can obtain information and guidance about health factors within my own control in order to nourish and support my overall health and wellness. Topics include; diet, nutrition, and related behaviors
2. I understand the purpose of Health Coaching and the benefits and risks, if any, associated with participation in the GemCare Wellness Health Coaching program.
3. I understand that results are not guaranteed.
4. I understand that GemCare Wellness Health Coaches do not dispense medical advice nor prescribe treatment. Rather, GemCare Wellness Health Coaches provide education to enhance my knowledge of health as it relates to food, dietary supplements, and behaviors associated with eating.
5. I understand that GemCare Wellness Health Coaching program is not intended for the diagnosis of any disease and is not a substitute for medical diagnosis, treatment, and/or care of a disease by a medical provider.
6. I understand that GemCare Wellness will keep appointment notes as a record of our health coaching sessions. These notes will document the topics discussed, interventions/plans, goals and progress.
7. I understand and agree to receive emails with tips, recipes, offers, products and more from GemCare Wellness.
8. All health history, personal information and medical records shared with GemCare Wellness will be kept strictly confidential unless I have signed an authorization for release or where disclosure is required by law. I agree to hold GemCare Wellness and their health coaches harmless for claims or damages in connection with our work together.

This contract between myself, and GemCare Wellness, Inc. I have carefully read this agreement and understand the terms and conditions of my voluntary participation in the Program. I have read the GemCare Wellness Participant Notice and Consent as of the date signed below or electronically recorded by the online registration system.