WellForm MD provides medical services related to weight management and non-medical wellness treatments. This disclaimer outlines the scope of our services, the limitations of our care, and important information about payment and insurance coverage. By using our services, you acknowledge and agree to the terms outlined below.
1. No Primary Care Services
- WellForm MD does not serve as a primary care provider.
- Clients should maintain a relationship with their primary care physician or relevant specialists for general health concerns and ongoing medical care.
- Our services do not replace routine medical care, emergency care, or specialist consultations.
2. Scope of Services
- WellForm MD specializes in weight management treatments and wellness services, including but not limited to body sculpting, red light therapy, and wellness coaching.
- Our treatments are elective and intended to support overall well-being.
- Results vary by individual, and no guarantees are made regarding specific outcomes.
- Clients assume full responsibility for their participation in treatments and acknowledge the associated risks.
3. Medical Consultation & Responsibility
- Clients should consult with their primary care provider before beginning any new wellness or weight management program.
- Any medical concerns beyond weight management must be directed to a licensed physician or specialist.
- Clients must disclose any pre-existing medical conditions, medications, or contraindications that may impact treatment.
4. Payment & Insurance Coverage
- WellForm MD does not accept insurance for services unless otherwise noted.
- All treatments and consultations must be paid out of pocket at the time of service.
- Clients are responsible for confirming whether their insurance covers any medical weight management services separately.
- Prepaid services, memberships, and packages are non-refundable unless otherwise stated.
5. Limitation of Liability
- WellForm MD is not responsible for dissatisfaction with results or any potential side effects associated with treatments.
- We do not diagnose, treat, or cure medical conditions outside of weight management services.
- Clients assume full responsibility for their decision to undergo treatments and release WellForm MD from any liability related to elective procedures.
- WellForm MD is not liable for any indirect, incidental, or consequential damages, except in cases of gross negligence or intentional misconduct.
6. Acknowledgment & Agreement
By using WellForm MD’s services, you acknowledge and agree to:
- The elective nature of our treatments and the lack of guaranteed results.
- The financial responsibility for all services rendered.
- The requirement to consult a primary care provider for non-weight management medical concerns.
- The limitations of liability as outlined above.
If you have any questions regarding this disclaimer, please contact us at:
WellForm MD
📧 Contact Form
📞 Phone: 515-724-9517
📍 Address: 2675 N Ankeny Blvd, #113, Ankeny, IA 50023
By booking an appointment or using our services, you agree to this Medical & Treatment Disclaimer without requiring a physical signature.