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Health Consultation Agreement and Release of Liability
with Astrid Pujari, MD, ABIHM

By signing this form, I, the above, understand and agree to the following:


Although Astrid Pujari is a medical doctor, and works as a health coach, Astrid Pujari is NOT serving as MY MEDICAL DOCTOR.


Astrid Pujari is serving as a lifestyle, health, and well-being coach, and is NOT providing healthcare, medical, or nutritional therapy services, or attempting to diagnose, treat, prevent, or cure any physical, mental, or emotional issue.


Using the services of Astrid Pujari requires that I HAVE A PRIMARY CARE DOCTOR IN MY STATE to serve me regarding my medical concerns.


The information provided by Astrid Pujari, or Astrid Pujari MD PS is for informational purposes only and is not intended to substitute professional medical advice, diagnoses, or treatment.


Although Astrid Pujari is a medical doctor, ALL information provided during an appointment, on the website, or in classes or training, is for informational purposes only, does not constitute medical advice, and does not establish any kind of patient-client relationship.


Astrid Pujari is not a licensed psychologist or specialist healthcare professional. Astrid Pujari’s services do not replace the care of psychologists or other healthcare professionals.


Astrid Pujari and Astrid Pujari, MD, PS and all employees and affiliates do not take any responsibility for actions I take, nor any harm or damage suffered resulting from the use or non-use of the information available in an appointment, on the website, in handouts or written materials, or in classes. I agree to use judgment and conduct due diligence before taking any action or implementing any plan or practice suggested or recommended.


Astrid Pujari does not make any guarantees about the results of the information applied and shares educational and informational resources that are intended to help me succeed in wellbeing, health, and fitness. I understand that my ultimate success or failure will be the result of my own efforts, my particular situation, and innumerable other circumstances beyond Astrid Pujari’s knowledge or control.


I agree to always seek advice from my physician or other qualified healthcare provider before undertaking a new health regimen.

I agree that I will not disregard medical advice or delay seeking medical advice because of information provided by Astrid Pujari or Astrid Pujari MD PS. I will not start or stop any medications without speaking to my medical or mental health provider.


RETROACTIVE EFFECTIVENESS:
I acknowledge that this agreement is effective retroactive to the first date of consultation services provided to me by Astrid Pujari.

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