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Path to Wellness/Dr. LaBorwit
Nutrition Services Agreement and Authorization

By scheduling your session with me, you acknowledge and agree to the following terms:

 

Scope of Service

Karen L Herb, MS CNS LDN IFMCP/Emerge Nutrition and Wellness, LLC is not a physician, and the scope of her consultation services does not include treatment or diagnosis of specific illnesses or disorders. If you, the client, suspect you may have an ailment or illness that may require medical attention, then you are encouraged to consult with a licensed physician without delay. Only a licensed physician can prescribe drugs and treat/diagnose illnesses. Any mention of drugs in the course of consultation is only for the purpose of providing a complete history of drugs that the client is taking and not for Karen L Herb, MS CNS LDN IFMCP/Emerge Nutrition and Wellness, LLC to judge the appropriateness of the medication. Any change in prescription or dosage is a decision the client makes with his or her physician.

 

Karen L Herb, MS CNS LDN IFMCP/Emerge Nutrition and Wellness, LLC focuses on wellness and prevention of illness through the use of lifestyle interventions and natural nutritional therapies to achieve optimal health. As a licensed nutritionist and functional medicine specialist, Karen L Herb, MS CNS LDN IFMCP/Emerge Nutrition and Wellness, LLC focuses on educating and supporting clients to assume more personal responsibility for their health by adopting habits and dietary and lifestyle adjustments to support optimal health. While people generally experience greater health and wellness as a result of embracing a healthier attitude, lifestyle, and diet, Karen L Herb, MS CNS LDN IFMCP/Emerge Nutrition and Wellness, LLC does not promise or guarantee results or protection from future illness.

 

By scheduling this consultation, you acknowledge that you understand that Karen L Herb, MS CNS LDN IFMCP/Emerge Nutrition and Wellness, LLC is a health consultant and not a physician and that you should see a doctor if you think you have a medical condition. Karen L Herb, MS CNS LDN IFMCP/Emerge Nutrition and Wellness, LLC will not be held liable for failure to diagnose or treat an illness, nor will she be liable for failure to prevent future illness.

 

Additionally, you promise to give Karen L Herb, MS CNS LDN IFMCP/Emerge Nutrition and Wellness, LLC directly or through Path to Wellness, a complete and accurate account of any medical conditions that you may have and any medications or supplements that you are taking.

 

Insurance/Fees

Karen L Herb, MS CNS LDN IFMCP/Emerge Nutrition and Wellness, LLC does not accept insurance and will not apply to insurance plans for benefits. Insurance companies may consider nutritional services to be non-covered as alternative care and may deny claims as non-standard care or as not medically necessary. You may apply for reimbursement from Medicare or insurance and understand that Karen L Herb, MS CNS LDN IFMCP/Emerge Nutrition and Wellness, LLC is not required to reimburse you for the difference between any reimbursed amounts.

 

You are responsible for paying in full for services rendered. Fees are due when services are rendered and do not include supplements or laboratory testing. Fees are generally billable at $150.00 per hour but other package options may be available as agreed. A $100 cancellation fee will be due for any cancellation made 24 hours or less before a scheduled appointment.

 

 

By scheduling this appointment, you agree and acknowledge the above and hereby waive and hold Karen L Herb, MS CNS LDN IFMCP/Emerge Nutrition and Wellness, LLC harmless from any and all claims arising from this agreement and/or your actions and participation in her nutritional recommendations.

Let me join your care team with Dr. LaBorwit 

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