Patient Agreement

This document includes 'Blair Complex Care' practice policies and guidelines set forth to allow me to best assist you with my services. Please read each guideline and type your full name in the response box below stating you understand, acknowledge and agree to the terms. Please sign your name at the bottom prior to submitting.

I understand that the role of a health coach is not to diagnose or prescribe, and does not replace or override medical advice from you or your child's Primary Care Physician

I understand that a 30 minute appointment is required at a minimum of once every 8 Weeks weeks, OR a 60 minute appointment every 12 weeks to remain an active patient and continue to receive access and support.

I understand that emails or text messages between appointments are intended to clarify questions/concerns pertaining to a current protocol or treatment plan.

I understand that emails/texts should not be used as an open forum for discussion on matters not pertaining to the current treatment plan, protocol, or patient progress.

I understand that emails/texts should contain simple, targeted questions. If further discussion is needed outside of that parameter, I understand I may be asked to schedule a 30 minute appointment when necessary.

I understand that the information and recommendations received from Blair Complex Care are tailored for my child's individual needs, and are intended only for myself (parent/caregiver) and should not be shared with others or posted on social media.

I understand when scheduling an appointment that the time will be displayed in Eastern Standard Time (EST), and that it is my responsibility to convert the time appropriately to my time zone/region. I understand that failure to do so may interfere with the schedule and could warrant a cancellation.

I understand I am ultimately responsible for implementing my child's treatment. I understand that Blair Complex Care will do their best to advise the recommendations they see fit for my child based on their needs with their experience and education. I understand that I will be educated on each recommendation. I understand that there is no guarantee that my child will have a positive outcome.

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