WELCOME. The doctors of chiropractic and other healthcare providers at this office are honored to be a part of your journey as Wellness Consultants to achieve better health. This consent outlines our practice, policies, and your consent to care utilizing this wellness program that you elect to enroll in.

FUNCTIONAL HEALTH: Doctors of chiropractic, as well as other holistic health providers practicing in a functional health model, view health as a continuum to optimal health from hidden imbalances and dis-ease. Rather than treating "disease" (e.g. cancer, hypothyroid, or multiple sclerosis), we address underlying metabolic, physiologic, and functional imbalances, intervening at root causes. One effect may be the ability to reduce or eliminate the need for medications, which must be done by your prescribing provider. As doctors of chiropractic or other health practitioners at our office, we do not prescribe drugs or perform surgery. Therefore, all changes to prescription medications must be made by your prescribing medical provider.

ALTERNATIVES: Alternatives include doing nothing, relying solely on drug therapy, or consulting with other providers. Chiropractic is a branch of the healing arts distinct from other branches (e.g. nursing, osteopathic, or allopathic). There are doctors in this practice that are doctors of chiropractic who have post graduate education and board certifications in functional medicine and/or clinical nutrition, and that we are not treating you for any disease regardless of the scope of chiropractic practice. Nonetheless, we encourage you to communicate with your other health providers about the care you receive.

RISKS: Nutritional remedial measures and supplements used in our practice are generally considered safe; however, they may involve some risks including, without limit, changes in blood sugar or gastrointestinal upset. They may also interact with certain drugs and may be inappropriate during pregnancy or while breastfeeding.

NO GUARANTEE: Every individual responds to program recommendations differently and no guarantee or assurance is made as to the results of care in any specific case, as care may not improve your condition or result in reducing medications. We can, however, speak of our experience treating functional imbalances, and the success seen in our office has been excellent. Success includes documented subjective and objective functional improvement.

PAYMENT, INSURANCE, AND REFUNDS: Payment for this program, wellness consulting visits, all services, tests, and supplements recommended or included is not conditional on response to participation in the program. There is no guarantee of insurance coverage. In order to seek insurance coverage, it is the members responsibility to seek reimbursement without the aid of Dr. Amy Denicke or from the office that recommended or sold you this program. Any insurance policy is an agreement between the member and their personal insurance carrier and the member is responsible for payment of wellness consulting, services, supplements, and tests associated with this program, whether or not they are covered by insurance. Prorated fees for unused, prepaid services included in this program are not refundable, even if the member wants to cancel at any time. No refunds are available for any product purchases at any time that doesn't adhere to Full Script's return policy or within the business policy where any supplements were purchased outside of Full Script. Any and all returns of supplements must be handled by the member and with Full Script separately or within the business that the supplements were purchased. Payment for this program is to be paid up front and in full unless a payment plan was set up and is agreed to be paid in full based on the plan selected. Supplements are additional and not included in program fee.

NOTICE TO READER: This program cannot be construed as a recommendation of medical treatment or medication. It is not professed to be physical or medical treatment nor is any such claim made. There are no medical recommendations or claims offered in any online course offered under Core Flex Wellness, affiliated businesses, or associated practices or for any of the vitamin or mineral regimens described in this program. No individual should undertake the program or any of its regimens without first consulting and obtaining the informed approval of a licensed medical practitioner. The author makes no warranties or representation as to the effectiveness of any online course offered under Core Flex Wellness and their affiliates.

The statements and supplements recommended have not been approved by the Food and Drug Administration.

I hereby acknowledge and agree:

1. The purpose of wellness consulting and any online course(s) is to improve the overall health, vitality and well-being of the body through nutritional education and the use of natural foods and non-medicinal nutritional supplements and lifestyle enhancements. Dr. Amy Denicke or affiliated healthcare practitioners within this program, do not diagnose diseases, disorders or conditions.

2. Dr. Amy Denicke is a Doctor of Chiropractic which allows her to practice according to the state rules and regulations of where she is licensed in Colorado. Other potential wellness consultants or health care practitioners that are managing your progress or care within the program will be represented within their particular scope of practice or authority.

3. As part of any health consulting services or online course inclusions, you may be asked to provide information concerning my physical habits, medical history, moods, energy levels, likes and dislikes, lifestyle and diet. This information is collected to enable the Wellness Consultant to: (i) assess your knowledge of nutrition, (ii) educate you about the benefits of sound nutritional practices and (iii) recommend dietary changes to improve your general health, vitality and overall well-being. The Wellness Consultant handling your case will hold this information in confidence and will not release or disclose this information to any other person, without your prior consent, except as required by applicable law unless it is disclosed within a group.

4. If the Wellness Consultant suspects the existence of disease, disorder or condition, you will be informed of this suspicion. However, you acknowledge this is not a diagnosis or conclusion about the state of your health and that you are directed to promptly consult a licensed Medical Physician about any suspected problems or potential medical issues that are suspected. Proper medical evaluation and/or treatment of a medical condition is to be rendered by a medical or approved doctor only.

5. Should you request the Wellness Consultant to recommend dietary changes and/or nutritional supplements to enhance your body’s natural ability to resist and/or overcome a known disease, disorder or condition, it is your responsibility to disclose the nature of the disease, disorder or condition and all other relevant details to the Wellness Consultant. If you have not previously consulted a licensed Physician about this disease, disorder or condition, you acknowledge that you are directed to promptly do so. You are not to alter or discontinue treatments prescribed by a licensed Physician or other licensed health professional without consulting the individual who prescribed the treatment.

6. In providing Wellness Consulting Services to you, the Wellness Consultant is relying upon the truth, accuracy and completeness of all information you have provided to them. Any recommendations you follow for changes in diet, including the use of nutritional supplements, are entirely your responsibility.

7. The Wellness consultants or offices associated with this program is in no way liable for your health or safety.

8. In consideration of your participation in the Wellness Consulting Services and online courses offered by this practice or at any affiliated practice, you hereby accept all risk to your health, including injury or death that may result from such participation and you hereby release the Wellness Consultant(s) and any affiliated practices, on your behalf and on behalf of your personal representatives, estate, heirs, next of kin, and assigns from any and all costs, claims, causes of action and damages arising from any and all illness or injury to your person, including your death, that may result from or occur as a result of your participation in the Wellness Consulting Services and/or online courses, whether caused by negligence or otherwise.

9. Participating in a protocol, program, a membership or an online course, you understand that any services or online courses that you undertake at Core Flex Wellness or affiliated practices are undertaken within your own free will. You accept that the ultimate responsibility for your overall health care is your own responsibility and that Core Flex Wellness and associated affiliates are here to support you in this. You understand that your practitioner reserves the right to determine which cases fall outside their scope of practice, in which event an appropriate referral for medical management will be recommended. You hereby agree to assume full responsibility for any manner of loss, injury, claim or damage whatsoever, known or unknown, incurred as a result of same and you, your heirs, executors, administrators or assigns for any loss, injury, claim or damage sustained as a result of your attendance and/or participation.

YOUR AGREEMENT:

I have read and fully understand this consent form, and understand that I should not register for this Wellness Program if any of my questions have not been explained to my satisfaction or if I do not understand any of the terms or words.

DO NOT REGISTER FOR THIS PROGRAM UNLESS YOU HAVE READ AND FULLY UNDERSTAND!

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