Live Lean Rx Florida Liability Waiver & Service Agreement
I consent to allow CTF LLC to use their Technology Systems, including its DEXA scanner, Fit3D ProScanner, and/or Metabolic Cart to perform a body composition scan, cardiovascular fitness test, and/or metabolic health test, with full knowledge and awareness that it is my choice to perform these tests with CTF LCC, D.B.A.: LIVE LEAN RX FL BOCA AND TAMPA LOCATIONS.
1. I do hereby release all representatives of CTF LLC that are 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 services, activities, or programs of CTF LLC.
2. I am voluntarily participating in the services offered by CTF LLC, including DEXA SCAN, FIT3D, RMR and VO2 Metabolic Analysis. I hereby agree to expressly assume any and all risks of injury and death resulting from participation in the aforementioned services.
3. I further hereby declare myself to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness that disqualifies me from receiving a DXA SCAN, RMR, FIT3D, OR VO2MAX ASSESSMENT from CTF LLC.
4. DEXA SCAN. a.) If I elect to participate in the DEXA Body Composition Screening Scan, it is my responsibility to proceed with full knowledge and awareness that this technology uses low-dose x-rays. b.) I understand that Live Lean Rx FL will auto-save my DXA Scan data on a secure DICOM platform through FITTRACE for their Medical Director to access and review my scan data, which is required by Florida Law under Administrative Code 64-E5. Live Lean Rx FL and FITTRACE will not, at any point, sell my personal information, scan data, etc. to any third party for solicitation purposes. Only authorized personnel within Live Lean Rx FL and FITTRACE will have access to my DEXA Scan information. It is my responsibility to reset my password via the link provided to me via email by FITTRACE after my DEXA Scan in order to view my scans and Physician remarks within 30 Days from the scan date, or access will be denied. I understand that Live Lean Rx Technologists and trained staff members other than the Medical Director or Referring physician CANNOT, under Florida Law, directly reference, confirm or deny results, read from the report, or discuss my DEXA Scan results on the day of my scan WITHOUT receipt of written review and recommendations from Live Lean Rx's Medical Director or Managing Physician first. Technologists and staff CAN answer questions regarding terminology on the report and wellness goal related topics. These results and recommendations about my DEXA Scan results will be available to view digitally via the FITTRACE Cloud Storage Platform. I understand that any attempt to bribe or harass staff into discussing my DEXA Scan results before such review is received from the Physician will result in automatic client-business relationship termination without a refund. PDF transmission of DEXA Scan reports are NOT provided unless a written request from the client is received by CTF LLC via email. Once approved, a PDF report of the DEXA scan results will be provided ONE time free of charge, and then a $10 fee for every time after will result upon each request.
5. I acknowledge that after I have completed the necessary medical screening process set forth by CTF LLC, that I have permission to participate or that I have decided to participate in these services and do hereby assume all responsibility for my participation. I also certify that I am not pregnant or trying to become pregnant.
6. I acknowledge that every time I return for a DEXA Scan or VO2Max service at CTF LLC, I will have to complete a follow up medical screening survey.
7. I take full responsibility for any action taken by me after my visit to CTF LLC. I do not hold any representatives of CTF LLC responsible or liable for any adverse effects or complications arising from the services, recommendations, or opinions offered by CTF LLC.
8. MEMBERSHIPS. If I should elect to purchase a pre-paid multi-test package (12 month membership) or 6 month auto-draft membership, I understand that it is my responsibility to utilize my purchases within the selected parameters of the package or membership guidelines. I understand that all pre-paid 3, 6, 9 and 11-pack membership package contents expire 12 months from the date of purchase and it is my responsibility to use the benefits within this timeframe. I also understand that it is my duty to cancel the auto-draft membership when prompted via email notifications otherwise the system will continue to auto-draft the membership fees until action is taken. No refund or credit will be issued to me by CTF LLC for failure to manage my membership status. Pre-paid membership package content expiration dates may be extended after approval from owners/managers, but no refund for unused pre-paid tests will be provided.
9. REFUND POLICY. If you are unsatisfied with your service or product, you may choose from ONE of the following options:
1) Complimentary re-test of the Same Service
Clients who are unsatisfied with the service(s) rendered will be permitted to receive ONE(1) complimentary service of the SAME service type as their original purchase. Client MUST notify the business within 30 DAYS of original purchase date of their dissatisfaction in order to be eligible to receive this method of compensation. Clients who select this option are NOT eligible for a refund of sale unless otherwise authorized by management.
2) Full or Partial Refund of Sale
If a client is unsatisfied with their purchase of the following 1) Single service 2) Multi-Test Package/ Annual Membership package, they may be eligible receive a Full or Partial Refund of their purchase as approved by management. Client MUST notify the business within 30 DAYS of original purchase date of their dissatisfaction in order to be eligible to receive this method of compensation. Multi-Test Package/Annual Membership package options are severely discounted, and are eligible to receive (1) partial refunds if a service or services included in the package have already been used or (2) Full refund if none of the services included in the package have been used.
EXCLUSIONS: Clients CANNOT receive a refund from this business for the following goods & services: (1) Any discount voucher offer purchased from Groupon, Living Social, or any additional sources of that nature You must contact those websites directly about their refund or credit policies. (2) Full or partially used/worn retail merchandise such as clothing, shaker bottles, supplements, heart rate monitors, or lab tests. (3) Any digital or hard-copy nutrition, lifestyle, or exercise plan/recommendation literature.
10. VOUCHER PURCHASES, PROMOTIONS OR DISCOUNTS. VOUCHERS: Clients who elect to purchase a discount voucher from a Third Party such as Groupon, Living Social, etc. are responsible for reading and agreeing to the fine print on their vouchers through these venues. CTF LLC will honor vouchers in the amount of (1) voucher per person (1) time as a New client. Clients who purchase vouchers for themselves in excess of (1) voucher is in violation of the Third Party guidelines and will be required to pay the remainder of the retail value of the services for which they intend to use the voucher for. DISCOUNTS & PROMOTIONS: All discounted rates and promotions are based on the retail values of the services.
You will be required to enter your credit card information upon booking/creating your appointment regardless of membership status or discounted voucher use.
You will not be charged unless you violate our booking policy guidelines, which include:
APPOINTMENT RESERVATIONS & ACCOUNT CREATION Every client/prospective client seeking the services of CTF LLC/ Live Lean Rx FL must adhere to the online booking process as indicated via the BOOK NOW button on www.liveleanrxfl.com. Clients are NOT permitted to (1) Reserve an appointment for SOMEONE ELSE under their login. (2) Create an account and/or fill out the Pre-Screening Survey for another person in order to reserve an appointment UNLESS the client in which you are doing this for is your minor child. Live Lean Rx FL Staff members are also not permitted by law to create an account or complete the pre-screening survey for the client. Special Exceptions for issues with online booking state that staff members can assist with account creation and appointment reservation AFTER the Pre-Screening form containing the Liability Waiver has been accurately completed and submitted by the client wishing to participate in CTF LLC/ Live Lean Rx FL services. If these issues arise, clients must inform the CTF LLC staff members via email or contact form on the website for assistance.
APPOINTMENT CONFIRMATIONS ARE MANDATORY (booking policy cont'd)
Out of consideration for our clients and staff, if you neglect to confirm your appointment by the following methods (1) via our MindBody Online system or (2) by notifying the office via leaving a voicemail or sending an email/text message at least 24 hours prior to your appointment, your appointment will automatically be cancelled.
CANCELLATION POLICY (booking policy cont'd)
If you (1) fail to confirm your appointment 24 hours prior to your scheduled services (2) confirm and fail to show up or (3) Cancel your appointment less than 2 hours prior to your reservation you will be automatically be removed from the schedule, charged a $25.00 fee and NO REFUND will be issued.
EMERGENCY AND SPECIAL CIRCUMSTANCE CANCELLATION (booking policy cont'd)
If you (1) Fall ill (2) Become involved in an accident (3) Experience other travel, health etc. circumstances beyond your control that cause you to miss or cancel your appointment outside the policy guidelines, your $25.00 fee may be refunded or waived upon proper communication from the client to our staff member at owner/manager discretion on a case by case basis.
FEE APPLICATION (booking policy cont'd)
Your $25.00 fee may be applied to your total purchase as a credit if you re-schedule and return for an appointment without another cancellation.
NO SHOW POLICY & LATE ARRIVAL NOTICE (booking policy cont'd)
We are a "by appointment only" facility, which means we do not have set staffed hours where someone is here for walk-ins. No walk-ins are permitted as our services require completion and approval of a Pre-Screening Medical Survey prior to appointment reservation.
A failure to inform the office by (1) calling (you MUST leave a message if we do not answer), (2) Text message to the business phone line or (3) by direct email to the location less than 2 hours prior to your scheduled appointment will result in an automatic early cancellation and a $25.00 fee charged to your credit card on file.
If we do not hear from you within 15 minutes past your appointment time after you have confirmed your reservation, our staff will move on to the next appointment or leave the office if you are the last scheduled appointment for the day. Re-scheduling can be done at your leisure online the same way you booked the appointment initially for another available date and time.