Nutritional Therapy: Informed Consent and Disclaimer 

Shari Wagemans, Restorative Wellness Practitioner and Functional Nutritional Therapy Practitioner.

Before beginning Nutritional Therapy with your Functional Nutritional Therapy Practitioner 

(“FNTP”), please read the following information carefully. 

NUTRITIONAL THERAPY GOALS

The fundamental goal of Nutritional Therapy is to encourage people to become knowledgeable 

about—and responsible for—their own health. Rewilding Wellness helps individuals reach their optimal level of overall health by supporting and bringing balance to the five foundations listed below. All five are built upon a single, solid base: a properly prepared, nutrient-dense diet. 

• Digestion & Gut Health

• Blood Sugar Regulation

• Fatty Acid Balance

• Mineral Balance

• Hydration

By supporting each of these foundations and helping clients adopt a more nutrient-dense diet, 

the body's chemistry can be brought back into natural balance, setting the stage for optimal 

health. Nutritional Therapy is not designed, however, to treat any specific disease or medical condition. 

A Functional Nutritional Therapy Practitioner is trained to evaluate your nutritional needs and 

make recommendations of dietary change and nutritional supplements, not medical diagnoses 

or prescriptions. No comment or recommendation from Rewilding Wellness should be construed as a 

medical diagnosis or prescription. 

Reaching optimal health requires sincere commitment, possible lifestyle changes, and a positive 

attitude. If you are not willing to change how you eat and live, Nutritional Therapy is not the right 

approach for you. Since every human being is unique on a biochemical level, we cannot 

guarantee any specific result from our programs. 

HEALTH CONCERNS

If you suffer from a medical or pathological condition, you need to consult with an appropriate 

healthcare provider. An FNTP is not a substitute for your family physician or other appropriate 

healthcare provider. A Functional Nutritional Therapy Practitioner is not trained nor licensed to 

diagnose or treat pathological conditions, illnesses, injuries, or diseases or prescribe medications. 

If you are under the care of another healthcare provider, it is important that you contact your 

other healthcare providers and alert them to your use of nutritional supplements. Nutritional 

Therapy may be a beneficial adjunct to more traditional care, and it may also alter your need for 

medication, so it is important you always keep your physician informed of changes in your 

nutritional program. 

If you are using medications of any kind, you are required to alert Rewilding Wellness to such use, as well as to discuss any potential interactions between medications and nutritional products with your 

pharmacist. If you have any physical or emotional reaction to Nutritional Therapy, discontinue 

their use immediately, and contact Rewilding Wellness to ascertain if the reaction is adverse or an 

indication of the natural course of the body's adjustment to the therapy. 

Laboratory testing is performed to determine areas of dysfunction and opportunities for healing, not in diagnosis or treatment. Lab testing can help reveal nutritional deficiencies and weaknesses and assist in guiding the process of rebalancing the systems of the body.

COMMUNICATION

Every client is a biochemical individual, and it is not possible to determine in advance how your 

body will react to the nutrients or supplements you need. It is sometimes necessary to adjust 

your program as we proceed until your body can begin to properly accept targeted nutrients 

geared to correct imbalances or deficiencies. It is your responsibility to do your part by: 

• Following the nutrition guidelines provided by Rewilding Wellness.

• Eating a properly prepared, nutrient-dense diet.

• Avoiding harmful foods, substances, and behaviours.

• Moving your body daily.

• Getting plenty of sleep, rest, and relaxation.

• Staying in contact with Rewilding Wellness so they can stay abreast of your progress and provide

the best course of action going forward.

If your other healthcare providers have any questions regarding Nutritional Therapy, they 

are free to contact Rewilding Wellness. 

CLIENT PRIVACY POLICY

During the course of Nutritional Therapy, Rewilding Wellness will ask that you provide relevant personal details and information relating to your background, health, lifestyle, etc. (hereafter referred to as “Information”), including but not limited to: 

• Your full name, physical address, email address, phone number, date of birth, etc.

• Your health history, including injuries, surgeries, prescriptions, etc.

This Information will be gathered from you via in-person interviews, questionnaires, evaluations, 

intake documents, phone, email, mail, video conferences, etc., and used to: 

• Help assess your nutritional needs.

• Make recommendations for dietary changes and nutritional supplements to support your

specific nutritional needs and goals.

• Comply with all legal and NTA training obligations.

To ensure the maximum benefit of Nutritional Therapy, it is important that your Information is 

accurate and up to date. If you notice any changes to your health, or begin taking new 

prescriptions/medications etc., please notify Rewilding Wellness as soon as possible. Some medical 

procedures may alter the timing or type of functional clinical assessment performed. Please notify your practitioner if you have had any procedures or changes in the last month. It is also your right as a client to access, update, or delete your records at any time. To do so, simply notify us in writing. We will retain your Information for the length of time you are a client, after which they will take reasonable steps to dispose of your Information in a secure fashion. 

Rewilding Wellness is committed to protecting client privacy and required to uphold the privacy best practices and the policies as laid out in the relevant legislation. For example, Australia (The Privacy Act 1988) and NZ (Health Information Privacy Code 1994). I will take all reasonable steps to protect your Information from unauthorized access, use, or disclosure by using strong passwords, up-to-date software on all devices, and locking file cabinets for physical documents. However, even the best security practices cannot guarantee that all stored data will be completely free from third-party interception or corruption. In accordance with privacy standards, your consent is required for me to collect, use, and disclose your personal Information. 

LEGAL DISCLAIMER

• All information provided is intended to be of a general natural only and is included for the sole purpose of providing general information. Material provided is not intended to constitute advice or any statement on which reliance should be placed. Users should seek advice as appropriate from a suitably qualified medical professional on all specific situations, health issues and conditions of concern to them.

• My goal is to encourage people to increased their knowledge and responsibility for their own health and to bring this to a personal optimal level. My work aim is to attempt to improve your health but is not designed to treat any specific disease or medical condition. Reaching the goal of optimum health, absent other non-nutritional complicating factors, require a sincere commitment from you, possible lifestyle changes and a positive attitude. Since every person is unique, we cannot and do not guarantee any specific result from our programs or information.

• The information provided is not suitable for independent professional health advice. Nothing contained in the information provided is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, not should it be used for therapeutic purposes or as a substitute for your own health professionals advice.

• If you suffer from any medical conditions, you should consult with an appropriate medical

professional before acting upon any information provided.

• The information provided may differ from traditional therapeutic care and may impact your medication needs. By acknowledging this disclaimer you undertake to consult an appropriate medical professional before actioning any changes to your medication or medical regime.

• By acknowledging this disclaimer, you also undertake to inform me of any

medication that you have been using or have been prescribed to be used or of any medical

issues you may suffer from.

• I make every effort to customise the information provided to each individual. You understand that each individual's body will react differently to the information provided (if acted upon) and that adjustments may be made, as necessary, throughout the course of the program.

• You agree and undertake to make your own enquiries and investigations in respect of any

information provided to you.

• If you do elect to rely upon information disclosed, you warrant that you have obtained the advice of a suitably qualified medical practitioner in connection with the effects of implementing any procedure or course of action contained in the information provided. For this purpose, you warrant that you will make yourself aware of any potential risks and have chosen to proceed with such action after careful consideration and acceptance of these risks.

• Information provided should not be treated as substitute to professional medical advice. If you require specific forms of medical advice, please consult an appropriately qualified medical practitioner. Never disregard the advice of an appropriately qualified medical practitioner because of information which has been relayed by Rewilding Wellness.

• I am not a physician and the scope of information provided does not include treatment or diagnosis of specific illnesses or disorders. The information provided by Rewilding Wellness does not deal with the treatment of disease but focuses on wellness through the use of natural nutritional therapies and implementing a healthy lifestyle and diet.

• Whilst people may experience improved wellbeing as a result of implementing a healthy

lifestyle and diet, this will not protect from future illness. The information provided to

you is not intended to ensure that no future illness may arise.

• Rewilding Wellness makes every effort to ensure the quality of the information provided and

updates the information regularly. Before relying on the information provided, however

clients should carefully evaluate its accuracy, currency, completeness and relevance for

their purposes, and should obtain any appropriate professional advice relevant to their

particular circumstances. Rewilding Wellness cannot guarantee and assumes no legal liability or

responsibility for the accuracy, currency, completeness or interpretation of the information.

• Rewilding Wellness may provide links and access to information that may include the views or

recommendations of third parties and does not necessarily reflect my views or indicate a commitment to a particular course of action. Rewilding Wellness shall not be liable in connection with such third-party information.

• You acknowledge that access to information and material provided by Rewilding Wellness is

undertaken at their sole and absolute risk and by accessing this information and material

and by choosing to rely upon this information and material, you expressly and irrevocably release Rewilding Wellness from any and all liability which may accrue as a direct or indirect result of your access and any reliance upon any data or information.

• Rewilding Wellness disclaim all liability arising from the provision of information, whether directly or indirectly and for that purpose, you hereby release Rewilding Wellness from any and all fines, penalties, claims, actions, demands, complaints, losses, proceedings or otherwise in relation to the provision of any information.

This legal disclaimer is in compliance with Australian and New Zealand law.