I give consent to Jason Brien, R. TCMP to provide holistic health medical counseling to myself or to the client for which I am legally responsible. The consult will provide information and guidance about health factors within my control: my diet, nutrition and lifestyle. I understand that Jason Brien is not an MD and does not dispense medical advice, nor will he diagnose or treat any medical condition, but will provide nutritional support and holistic education for an already diagnosed condition. He provides information to enhance my knowledge of health through the use of whole foods, dietary supplements, herbs and emotional awareness. While nutritional and botanical support can be an important complement to my medical care, I understand these services are not a substitute for medical care. Methods of nutritional evaluation or testing made available to me are not intended to diagnose disease. Rather, these assessment tests are intended as a guide to developing an appropriate health support program for me, and to monitor my progress in achieving my goals. Medical records, personal information and history divulged in session to Jason Brien will be kept confidential, unless I consent to sharing my medical information.

I agree to hold Jason Brien harmless for claims or damages in connection with our work together. This is a contract between myself and Jason Brien and I understand that it is also a release of potential liability.

By writing my name below and checking “Agree”, I agree to these terms.

Dec 8, 2021