​Dr. Astrid Pujari and her medical and intuitive coaching practice known as Astrid Pujari MD (both will referred to here, either individually or in conjunction, as DR. PUJARI) is not serving as a primary care physician, but as a consultant. Using the services of DR. PUJARI requires that I have a primary care doctor in my state to serve me regarding my medical concerns. For emergencies, I understand that I must go to the emergency room or call 911.

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The cost of an Integrative Medical Coaching Package is $2,222.00 if paid in full on registration, or, if paying monthly, $215.00 per month for a total of $2,580.00.

If paying monthly, the first payment must be paid before the baseline labs are done, and will be equal to 2 months’ payment, for a total of $430.00. After the first payment, $215.00 will be charged to my credit card on file on the first day of each month, beginning the month after the first payment, and continuing for the next 10 consecutive months, until my payment obligation is complete. Please initial below to indicate which payment plan you choose.

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I understand that I am responsible for scheduling and completing all the elements of this package within 365 days (1 year) of signing this contract. If for any reason, I do not complete any of the elements of this package within 365 days, I hold DR. PUJARI harmless and I forfeit any incomplete elements with no refund. I understand that if I do not complete any element of this package within the designated time period, I will have to pay the full amount regardless of circumstances.

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Elements included in this package are the following:

• One (1) 90-minute intake with DR. PUJARI

• Four (4) 30-minute follow-up appointments with DR. PUJARI

• One (1) 1-hour consultation with Emily Ziedman, MS, CN, AWC, a Certified Nutritionist

• One (1) set of baseline labs and one (1) hormone panel*

*If I have had labs and a hormone panel run recently which meet the criteria required by Dr. Pujari and do not wish to do more lab work, I may exchange baseline labs for an additional 1-hour consultation with Emily Ziedman, MS, CN, AWC.

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My baseline labs and hormone panel will be done prior to my first appointment, and will be ordered by Dr. Pujari's office as soon as I have submitted this contract and made my first payment or payment in full. As described in detail in section #4, I may substitute the baseline labs and hormone panel with one additional nutrition appointment with Emily Ziedman. My labs and panel will entail having my blood drawn at a LabCorp location of my choosing. I understand that the exact labs and panel drawn are part of a standardized set, intended to provide an overview and screening of general health. These tests are predetermined by DR. PUJARI and substitutions, additions, or any other adjustments are not permitted. I understand that ANY additional labs beyond those specified in the package that are recommended based on health conditions discussed in my appointments or requested by me, WILL NOT be covered as part of the package cost, and I will be required to pay additionally for those labs. Please initial below to indicate that you understand and agree to the terms of getting lab work done.

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Appointments with DR. PUJARI will be conducted either virtually, or in-person. In-person visits are available ONLY at her office; either at the current address of 20006 Cedar Valley Road, Ste. 203, Lynnwood, WA 98036, or a new address, which I will be notified of, should her office move to a new location.

The nutrition consultation with Emily Ziedman, MS, CN, AWC, is a 1-hour visit, and is virtual only.

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DR. PUJARI 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.

DR. 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 DR. PUJARI’s knowledge or control.

I agree to always seek advice from my primary care physician 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 DR. PUJARI. I will not start or stop any medications without speaking to my medical or mental health provider. 

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DR. PUJARI does not bill your insurance directly for any services provided. Once my Integrative Medical Coaching Package has been paid in full, I may request that DR. PUJARI send me a “super bill” to submit to my insurance company for potential reimbursement, provided I:

• Live in Washington state.

• Understand that my super bill includes my appointments with DR. PUJRI only, at a rate of $385.00 per appointment, and a total of $1,155.00. All other services included in the Integrative Medical Coaching Package are not eligible for potential reimbursement.

• Understand that DR. PUJARI does not guarantee that my insurance company will reimburse me for any appointments, and that researching my policy, submitting my claim, and communicating with my insurance company is my sole responsibility.

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This Integrative Medical Coaching Package is nonrefundable or transferable.

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I understand that I may not be eligible for a medical coaching appointment, and should that be the case, this agreement is null and void and will be destroyed by the office of Astrid Pujari, MD.

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I agree that in order to finalize my registration I must provide a signed copy of this agreement as well as a valid credit card number to the office of DR. PUJARI. I will also provide all additional paperwork requested of me and submit any health documentation that may be relevant so that DR. PUJARI may review it prior to your first appointment.

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Please provide the requested information and your signature below. By signing this agreement, you signify that you have read and understood all information therein and agree to all terms and conditions.​​​​​