Client Self-Declaration & Nutrition Assessment Form
All information is confidential & securely stored
Current Diagnosed Medical Conditions
I hereby declare that the information provided above is true and accurate to the best of my knowledge. I understand that the nutritional advice and meal plans provided are based on the information I have disclosed and are not a substitute for professional medical care or diagnosis.
I acknowledge that the nutritionist and associated personnel are not liable or responsible for any unforeseen health issues, complications, or adverse reactions that may occur as a result of following the nutritional recommendations. I take full responsibility for my health decisions and understand that it is my duty to consult a physician for any medical concerns.
