Consent Terms
Functional Medicine Institute's PROGRAM CONSENT TERMS
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1. You acknowledge that the nature and purpose of Functional Medicine Institute's treatment protocol have been explained to you whenever necessary and you have been given the opportunity to ask questions.
2. You understand that a change of medical condition or medications, can affect the protocol or treatment outlined by Functional Medicine Institute. You recognize the importance of notifying Functional Medicine Institute of any changes in your health and you agree to do so immediately.
3. You understand that Functional Medicine Institutedoes not handle acute health conditions and you will need a Primary Care Physician / Family doctor to attend to any of my medical emergencies while you are on Functional Medicine Institute's Treatment protocol.
4. You understand the key to healing is your commitment to comply with prescribed dietary changes, supplements, and medications and other treatment recommendations. If you don’t follow the plan with reasonable consistency, your progress will likely be stalled.
5. You agree and give consent to Functional Medicine Institute to access and share your details mentioned in the form including personal details and medical records, with the team involved in your care and treatment. You agree and give consent for this data to be used for research and publication purposes.
6. You understand Functional Medicine is a different approach from the existing health care model. Functional Medicine is an evidence based, systems biology approach that focuses on identifying the root cause of the disease.
7. You hereby release and discharge Functional Medicine Institute from any potential claim, loss, damage etc. (“Loss”) that you may suffer as a result of, or occurring out of, or due to any treatment recommended by Functional Medicine Institute under their program. In the event you suffer such Loss due to – (i) your non-adherence of the instructions and guidelines recommended by Functional Medicine Instituteor (ii) concealment, whether complete or partial, of any medical condition, history, treatment or allergy(ies) that you may have or are suffering with.
8. Functional Medicine Institute shall not be liable to you for any incidental, indirect, consequential or, special damages. Functional Medicine Institute's total liability shall not exceed, under any circumstances, the subscription amount paid by you to Functional Medicine Institute.
9. All claims / disputes shall be subject to exclusive jurisdiction of courts at Bangalore and this choice of location will be determined at Functional Medicine Institute’s sole discretion.
The above mentioned terms and conditions are generally applicable to all services, programs and products offered by Functional Medicine Institute.
If you have any questions please contact us at info@functionalmedicineclinic.in