Health Bridge
Health and Wellness Coaching Sign-up Form
We are here to help. Being ill can be a lonely road with more questions than answers. We would like to help you through evidence-based lifestyle recommendations. Let us be you companion on your journey back to health! By filling out this form, you are not agreeing to any payments. We would just like to know why you have reached out to us.
Disclaimer:
Health Coaching Services
Please read this disclaimer carefully before proceeding with health coaching services. The health coach, Health Bridge, is a health coach providing services focused on general wellness and lifestyle improvement. Coaching services are for educational and motivational purposes only, designed to support and assist in reaching health and wellness goals.
Important limitations:
Not Medical or Mental Health Advice: The health coach is not a medical doctor, registered dietitian, licensed therapist, or any other licensed healthcare professional. The information and guidance provided during coaching sessions are not intended to diagnose, treat, prevent, or cure any medical or mental health condition, disease, or illness. Always seek the advice of a qualified healthcare provider (e.g., physician, psychiatrist, therapist, registered dietitian) regarding any questions or concerns about specific health, medications, supplements, or before starting any new health or wellness regimen. Do not disregard or delay seeking medical advice based on information obtained through coaching services.
Personal Responsibility: The client acknowledges and understands that they are solely responsible for their own physical, mental, and emotional well-being, as well as the decisions, choices, actions, and results that may arise from or relate to their participation in coaching sessions.
No Guarantees: While the goal is to support the journey toward improved health and wellness, specific outcomes are not guaranteed. Success depends primarily on individual effort, motivation, commitment, follow-through, and various external factors beyond our control.
Confidentiality: All information shared during coaching sessions will be treated as confidential, except where disclosure is required by law (e.g., child abuse, elder abuse, imminent threat of harm to self or others). We abide by HIPAA and will always ask you before sharing your data with anyone.
By signing this intake form, the client acknowledges that they have read and understand this disclaimer and agree to its terms and conditions. The client voluntarily chooses to participate in health coaching services with a full understanding of the limitations outlined above.
Please fill out the form below to see if we are the right fit:
