I am voluntarily requesting pharmacist-led health-coaching services from CounterMend ("the Service") for the chronic-disease management of a condition already diagnosed and being managed by my existing clinicians. I understand that the Service does not replace emergency care, primary care, specialist care, controlled-substance prescribing, imaging, or surgery, and that CounterMend coordinates with — and refers me back to — those clinicians where appropriate.
I acknowledge that the coaching, education, and medication review provided by the Service are not a substitute for independent medical judgement from my own physicians. I have either disclosed, or agree to disclose upon request, every prescription, over-the-counter medication, dietary supplement, and relevant medical history that bears on the Service's review. I understand that the Service's recommendations depend on the accuracy and completeness of what I share, and that the Service cannot be held responsible for outcomes that depend on information I have withheld or provided incorrectly.
I understand that the Service carries no independent guarantees of outcome: any specific health result, medication change, lab reading, or symptom improvement depends on factors outside the Service's control, including my own adherence, my body's response, and decisions made by my prescribing physicians. I voluntarily assume the ordinary risks of medication review and lifestyle coaching as practised by a licensed pharmacist within the scope of their licence, and release and discharge the Service, its pharmacists, and its staff from liability for any loss, injury, or damages arising from those ordinary risks, to the maximum extent permitted by applicable law.
I understand that this waiver does not extend to claims arising from the gross negligence, recklessness, or intentional misconduct of the Service, its pharmacists, or its staff, and that nothing in this waiver is intended to override a jurisdiction's mandatory patient-protection rules where they apply. I have read this waiver in full, I have had a reasonable opportunity to ask questions of CounterMend before accepting, and I am accepting it freely and without coercion.
DRAFT — pending attorney review