Program informed consent for nutritional clients
The client gives consent for Mirela Simic to provide nutrition and health coaching to him/herself or the individual for which he/she is legally responsible. The client understands that Mirela Simic is a registered nutritionist, not a licensed medical physician. She does not claim to treat, cure, or diagnose any specific disease or medical condition.
The nutrition and health advice given by Mirela Simic is solely based on the information provided by the client. It is the client’s responsibility to provide complete and accurate information. Any misinformation, inaccurate or omitted information may affect the assessment and/ or recommendations given. All personal information the client shares with Mirela Simic will be kept strictly confidential unless the client consents to share it.
The services provided by Mirela Simic are intended to help the client meet his/ her nutrition and health goals and may complement the care of other health care providers but are not a substitute for medical care. Any assessment methods that the client takes part in will serve as a guide to help him/her and Mirela Simic to develop an appropriate nutrition and health program tailored to his/her individual needs. It is the client’s responsibility to decide which dietary and lifestyle changes to follow and to discuss any potential risks and benefits of these changes with the Mirela Simic nutritionist and the client’s other healthcare provider(s). It is important that the client keep the other member(s) of his/her healthcare team informed of any changes to their nutrition and health program as a result of working with Mirela Simic.
Every client is an individual and it is not possible to determine in advance how he/she will do when starting a nutrition program. It is sometimes necessary to adjust the client’s program and it is important that he/she stays in contact with Mirela Simic regarding his/her progress and any concerns or questions he/she may have in order to proceed with the best course of action. The client acknowledges and understands that no warranties or representations have been made to him/her regarding the results he/she will achieve from this nutritional program. The client understands that results are individual and may vary.
In addition, the client agrees that all of the information he/she receives from Mirela Simic is for the client’s personal use and he/she will not share, copy, or distribute them to third parties. No part of this information may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any means including, but not limited to, electronic, mechanical, photocopy, recording without the prior written permission of Mirela Simic.
The client may be in contact with Mirela Simic using email communication to relay such items as appointment times and for brief check-ins to discuss progress. Because it is not possible to guarantee the security of this form of communication, it is generally not recommended that the client share other personal health information. However, it is the decision of the client what to include in his/her email communication and he/she takes full responsibility for the security of this information.
By completing this form, a client gives Mirela Simic on behalf of the Melas Nutrition and Training Pty. Ltd. full permission to take photographs, slides, and videos of client and to use those to promote or advertise Melas Nutrition and Training Pty. Ltd. on their website, social media or any other type of advertising. This consent can be withdrawn by sending email to email@example.com.
Please note: All information which you provide to us here, and during your consultation, is bound by patient-practitioner privacy laws and will remain private unless the following circumstances occur:
You admit to criminal activity
You are a danger to yourself or others
Your information is subpoenaed by a court of law
You provide a written request to us to contact any existing health care providers with your progress notes or reports.
(a) Melas Nutrition and Training Pty ltd respects your right to privacy and is committed to safeguarding the privacy of our customers and website visitors. We adhere to the Australian Privacy Principles contained in the Privacy Act 1988 (Cth). This policy sets out how we collect and treat your personal information.
(b) “Personal information” is information we hold which is identifiable as being about you.
(a) Melas Nutrition and Training Pty ltd will, from time to time, receive and store personal information you enter onto our website, provided to us directly or given to us in other forms.
(b) You may provide basic information such as your name, phone number, address and email address to enable us to send information, provide updates and process your product or
service order. We may collect additional information at other times, including but not limited to, when you provide feedback, when you provide information about your personal or
business affairs, change your content or email preference, respond to surveys and/or promotions, provide financial or credit card information, or communicate with our customer support.
(c) Additionally, we may also collect any other information you provide while interacting with us.
(a) Melas Nutrition and Training Pty ltd may use personal information collected from you to provide you with information, updates and our services. We may also make you aware of new and additional products, services and opportunities available to you. We may use your personal information to improve our products and services and better understand your needs.
(b) Melas Nutrition and Training Pty ltd may contact you by a variety of measures including, but not limited to telephone, email, sms or mail.
(a) We may disclose your personal information to any of our employees, officers, insurers, professional advisers, agents, suppliers or subcontractors insofar as reasonably necessary for the purposes set out in this Policy. Personal information is only supplied to a third party when it is required for the delivery of our services.
(b) We may from time to time need to disclose personal information to comply with a legal requirement, such as a law, regulation, court order, subpoena, warrant, in the course of a legal proceeding or in response to a law enforcement agency request.
(c) We may also use your personal information to protect the copyright, trademarks, legal rights, property or safety of Melas Nutrition and Training Pty ltd, www.melasnt.com.au, its customers or third parties.
(d) Information that we collect may from time to time be stored, processed in or transferred between parties located in countries outside of Australia.
(e) If there is a change of control in our business or a sale or transfer of business assets, we reserve the right to transfer to the extent permissible at law our user databases, together with any personal information and non-personal information contained in those databases.
This information may be disclosed to a potential purchaser under an agreement to maintain confidentiality. We would seek to only disclose information in good faith and where required by any of the above circumstances.
the types of a disclosure covered by this Policy. Where we disclose your personal information to third parties, we will request that the third party follow this Policy regarding handling your personal information.
(a) Melas Nutrition and Training Pty ltd is committed to ensuring that the information you provide to us is secure. In order to prevent unauthorised access or disclosure, we have put in place suitable physical, electronic and managerial procedures to safeguard and secure information and protect it from misuse, interference, loss and unauthorized access, modification and disclosure.
(a) You may request details of personal information that we hold about you in accordance with the provisions of the Privacy Act 1988 (Cth). A small administrative fee may be payable for the provision of information. If you would like a copy of the information, which we hold about you or believe that any information we hold on you is inaccurate, out of date, incomplete, irrelevant or misleading, please email us at firstname.lastname@example.org.
(b) We reserve the right to refuse to provide you with information that we hold about you, in certain circumstances set out in the Privacy Act.
(a) If you have any complaints about our privacy practices, please feel free to send in details of your complaints to 160 Bestic str, Kyeemgh, New South Wales, 2216. We take complaints very seriously and will respond shortly after receiving written notice of your complaint.
(a) When you visit our website
When you come to our website (www.melasnt.com.au) we may collect certain information such as browser type, operating system, website visited immediately before coming to our site, etc. This information is used in an aggregated manner to analyse how people use our site, such that we can improve our service.