WELCOME!

By now, you’ve probably been sent a few emails explaining what to expect. Please do not hesitate to contact me at any time if you have any questions or if you require further explanation.

Please complete this well-being assessment to help you and I to evaluate the effectiveness of of working together and your progress.

*Please note that all of your personal information, including your name, your email address, your correspondence, etc. is held as private and confidential.

MY AGREEMENT OF RELEASE OF LIABILITY

In consideration of receiving coaching services Donna DeCunzo-Taddeo, and, in that process, to be coached in fitness, nutrition, weight management, stress management, mental health, and/or health risk management, I do hereby waive, release, and forever discharge my coach, Donna DeCunzo-Taddeo and from any and all responsibility or liability for injuries or damages resulting from my participation in any activities or my use of fitness equipment arising out of my participation in any activities under such coaching. I do also hereby release Donna DeCunzo-Taddeo and any others acting upon their behalf from any responsibility or liability for any injury or damage to myself, including those caused by the negligent act or omission of any of those mentioned or others acting on their behalf or in any way arising out of or connected with my participation in any activities of wellness coaching. I understand that as a part of my wellness coaching program, I may be coached to, or it may be suggested that I, participate in exercise activities, e.g., exercise, aerobic training, strength training, flexibility training, etc., that could be potentially hazardous. I also understand that such activities involve risks of injury and even death, and that I am voluntarily participating in these activities and using equipment and machinery with knowledge of the dangers involved. I hereby agree to expressly assume and accept any and all risks of injury or death. I do hereby further acknowledge that I have either had a physical examination and have been given a physician’s permission to participate or that I have decided to participate in activity and or use of equipment and machinery without the approval of my physician and do hereby assume all responsibility and risks of injury or death from such participation and activity.

PLEASE NOTE: By clicking the “ink below, and proceeding to complete the Wellness Assessment, you are indicating that you accept the above agreement of release of liability and the terms of the well-being assessment.

I accept the above agreement of release of liability and the terms of the well-being assessment.


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