Welcome to Boundless Health with Dr. Bret Scher! As we begin on our journey together to Health and Fitness, we first want to know more about you. Please take the time to fill out this medical history form prior to your first session. All information will be treated as protected medical information under HIPPA laws and will be shared only among Boundless Health practitioners. The form is extensive, but please try to make it as accurate and complete as possible. Your answers will help us design a comprehensive program that meets your individual needs.
THIS CLIENT AGREEMENT ("Agreement") is entered into as of the date set forth on the signature page to this Agreement by and between Boundless Health, Inc., a California corporation ("BH") and the Client whose name is set forth on the signature page to this Agreement ("Client"), who agree as follows:
A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS/HER FAVOR AT THE TIME OF EXECUTING THIS RELEASE WHICH IF KNOWN BY HIM/HER MUST HAVE MATERIALLY AFFECTED HIS/HER SETTLEMENT WITH THE DEBTOR.
Welcome to Boundless Health, Inc. ("BH" or "we"). We are excited to embark on this journey with you on your path to health and fitness. BH aims to be a multimodality center to help you with every aspect of your health. Our services are performed for your information and to help us at BH formulate your individualized health and wellness plan. They are not intended to be part of your official medical record.
We do not intend to take over your medical care as your physician of record. BH is not a medical facility and does not provide comprehensive traditional health care services. However, we do intend to work closely with your treating physicians, and with your permission we can share our findings with them. In addition, we may make suggestions to your treating physicians based on our findings and your participation in our programs. The ultimate decision on further diagnostic tests and treatments will be at the sole discretion of your treating physician.
The information and services provided by BH are for informational and educational purposes and are not intended to be used for medical diagnosis or treatment. BH is not engaged in the practice of medicine and the recommendations of BH should not be relied on or used as a substitute for consultation or seeking medical care from your physician or other qualified health care professionals. You should always consult with your physician or other qualified healthcare provider about questions concerning a medical condition, and before starting, stopping or modifying any treatment or medication.
BH strives to follow HIPPA regulations and protect your privacy. By agreeing to participate in the services offered by BH, you are giving permission for us to discuss your health freely among BH providers. We will always ask for specific written permission to share your information with a provider outside of BH.
If you have any questions or concerns about our privacy policies or our role in your healthcare, please do not hesitate to ask for clarification.
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