Client Consent
Practitioner Scope
Madison Dohnt is a University-qualified Naturopath, Nutritionist, Scientist and Educator, specialising in women’s health and hormones. The Practitioner provides women with holistic health services and education, with the goal to help them reach their highest potential through nutrition, exercise, gut health, mental health, and other pillars of natural health; and allowing them to become knowledgeable and intentional about their diet and lifestyle choices. Consultation topics and content will vary depending on Client's personal needs, goals, desired outcomes, priorities and other factors.
The Practitioner offers Services in the form of Health, Nutrition and Mindset Coaching as well as Naturopathic Consultations and Supplement Prescriptions (herein collectively referred to as “Services”). Health Coaching is tailored personal development geared towards helping Client learn about a holistically healthy lifestyle. Nutrition Coaching is assisting Client to learn nutrition fundamentals and utilise these principles to make healthier eating choices. Mindset Coaching is assisting Client to work through limiting beliefs and overcome mindset obstacles to build confidence and reduce stress, in an effort to benefit Client’s goals.
The Practitioner is not a doctor, nurse, dietician, physical therapist, occupational therapist, psychiatrist, psychologist, therapist, personal trainer, counselor, business operations manager, financial analyst, or other agent. The Practitioner may offer her opinion regarding health and/or personal decisions, but it is the responsibility of Client to make the final decision and choose the best option for his/herself. Client also acknowledges that health services cannot come with any guarantees of a perfect outcome. Client hereby acknowledges that Client is solely responsible for the amount and type of progress that Client achieves by implementing techniques and advice provided by Practitioner and remaining compliant with their treatment plan and prescription.
Client Responsibilities
Client accepts and agrees that Client is 100% responsible for his/her results, 100% of the time. Client acknowledges that he/she can optimise their potential results from the Program by adhering to the following:
Payment, Rescheduling and Refund Policy
We understand that sometimes, “life happens.” In order to accommodate situations that unexpectedly arise, all requests to reschedule a call must be made no later than 24 hours before the scheduled call. Nothing in this clause is intended to exclude any right or guarantee to which you are entitled under the Australian Consumer Law. All prices are in AUD (Australian Dollars).
Practitioner reserves the right to end the consultation “for cause” at any time, which includes, but is not limited to, the following causes: 1) Client is abusive or harasses Practitioner or other members of Madison Dohnt Pty Ltd; 2) Client payment fails; 3) Client proves to be difficult to work with and/or shows up more than 15 minutes late; 4) for any other legitimate reason. If any of these causes trigger Practitioner to terminate the Agreement, Client is deemed at fault and still liable to pay the entire cost of the consultation.
Confidential Information
Madison Dohnt Pty Ltd takes pride in its proprietary information included in each Program. As such, Client agrees and acknowledges all Confidential Information shared through this Program and by the Practitioner is confidential, proprietary, and belongs exclusively to Madison Dohnt Pty Ltd.
Confidential Information includes, but is not limited to:
Client agrees not to disclose any of Madison Dohnt Pty Ltd and/or Practitioner’s Confidential Information.
Madison Dohnt Pty Ltd also takes seriously its responsibility to protect Client’s personal information and privacy. As such, consider this a mutual non-disclosure agreement. Madison Dohnt Pty Ltd agrees not to disclose any of Client’s personal information. Please see full privacy policy here.
Client agrees to Practitioner sharing general statements about Client’s success and unidentifiable screenshots of messages as social proof and part of its marketing strategy; though this may only involve Client’s first name and is therefore unidentifiable. With Client’s permission only, Client’s photo may be included. Practitioner may also ask if the Client will provide testimonials about the Practitioner and the Program, via video, audio or written testimonials. If provided, the Client grants the Practitioner permission to use the testimonial publicly for marketing as she sees fit. Both parties will keep Confidential Information in the strictest confidence and shall implement the best effort to protect Confidential Information from disclosure, misuses, misappropriation, loss, and theft. As part of the Program, Client information may be used with secure programs and software including: Voxer, Kajabi, Dubsado, Stripe, Google Drive, Simple Clinic, Dispensary Platforms, Nutritional Analysis Software, Gmail and other software where necessary. Practitioner will not disclose any of Client’s personal information to additional third-parties without prior written consent.
Intellectual Property
Madison Dohnt Pty Ltd and its Programs may use free stock photography as part of its design. All stock images used have an irrevocable, non-exclusive copyright license to download, copy, distribute, use and modify the photos for free, including for commercial purposes. Use of said stock photography is permissible under applicable laws without permission from the photographer or attributing the work to the photographer.
This website, content and products contain intellectual property owned by Madison Dohnt Pty Ltd and by third-parties that license some intellectual property to us. This Agreement is intellectual property owned by Madison Dohnt Pty Ltd. Other examples of intellectual property found on our website and within our products and Services include, but are not limited to: trademarks, service marks, layout, logos, business name, design, text, written copy, certain images, podcast recordings, videos, audio files, and all of our paid products (collectively referred to as “Intellectual Property”). You shall not copy, publish, transmit, transfer, sell, create derivative works from, reproduce, or in any way exploit any of the Intellectual Property owned by Madison Dohnt Pty Ltd and the third-parties described within this Section in either whole or part without prior written consent.
Limited License
Madison Dohnt Pty Ltd grants only a limited license to Client to use the Intellectual Property. You acknowledge that any and all products or Services that you download are for your own personal use. You shall not copy, reproduce, transmit, modify, edit, create derivative works from, alter, sell, or share with others any products or parts of the Program without prior written consent or unless provided otherwise, which may incur a fee. Madison Dohnt Pty Ltd grants you a limited, personal, non-exclusive and non-transferable license to use the Program for your personal use.
Client holds a limited license during the Term of this Agreement to use Practitioner’s proprietary program. Client must not misappropriate any of Practitioner’s intellectual property and proprietary information in the following manner:
Indemnification/ Limitation of Liability
Practitioner provides lifestyle guidance as part of her Program. Client hereby acknowledges that neither Practitioner nor Madison Dohnt Pty Ltd is liable for any injuries that may arise from Client’s personal decisions based off of his/her participation in this program, including but not limited to: a decision to leave a job, leave a relationship, change their living environment, a decision to invest in an opportunity, a decision to start a business, any of Client’s business decisions, any of the Client’s health decisions, any of Client’s financial decisions. Client hereby agrees to indemnify and hold harmless both Practitioner and Madison Dohnt Pty Ltd of any claims that may arise after participation in the Program. Client also agrees that he/she is solely responsible for any decision regarding his/her personal health and indemnifies Practitioner from any liability regarding said decision. Client agrees that Practitioner is not responsible for any physical injuries, diseases, illnesses, or other health conditions that might arise during or after the Program; and agrees to hold Practitioner harmless of any liability regarding any diagnosis of any such injury or health condition. If Client is aware of a pre-existing injury, disease, or health condition, Client hereby acknowledges that he or she has consulted a doctor and made the Practitioner aware.
Miscellaneous
Amendments - We reserve the right to amend this Agreement from time to time. Any amendments must be agreed in writing and executed by both parties.
Headings & Severability - Headings are included for convenience purposes only and shall not affect the construction of this Agreement. If any portion of this Agreement is held to be unenforceable, it shall not affect the remaining portions of the Agreement, which shall remain in full effect. If any portion of this Agreement is held to be unenforceable, then the unenforceable portion shall be construed in compliance with applicable law in a light most favourable to the original intentions of the parties. If the unenforceable portion of the Agreement is found by a competent court of this jurisdiction to be contrary to law, then it shall be changed and interpreted to best reflect the original intentions of the parties, and all other provisions shall remain in full force and effect.
Entire Agreement - This Agreement reflects the entire agreement between the parties. This Agreement trumps any other existing negotiations, communications or Agreements between the parties, whether written, oral, or electronic, and is the full extent of the Agreement between the parties.
All Rights Reserved - All rights not expressly granted in this Agreement are reserved by us.
Governing Law - Madison Dohnt Pty Ltd is located in Queensland, Australia and is subject to the applicable laws governing Queensland, Australia. The governing law for this agreement is the laws of Queensland, Australia.
Arbitration - Any disputes arising under this Agreement shall first be resolved through a binding arbitration.
Execution - This Agreement may be signed digitally. Electronic signatures shall be deemed valid.
Agreement - By signing this Agreement, Client agrees to make all payments. Client hereby acknowledges and agrees to abide by all policies and procedures contained within this document and expresses assent to the terms.
- I consent to clinical assessment and treatment by the practitioners at Modern Balance
- I understand that treatment conducted at the Modern Balance clinic does not take the place of medical treatment where needed and it is my responsibility to inform my practitioner of any illnesses, injuries, medication conditions or procedures and any other information regarding my health.
- I understand that my practitioner will take treatment notes to help with my treatment.
- I understand that whilst I am not obliged to provide any information, failure to provide full health details requested above or during consultations may compromise the quality of treatment provided.
- I understand that a 50% cancellation or no-show fee will apply to all appointments changed within 24 hours. The no-show policy allows for three instances and may result in suspension from the clinic for one year.
- I hereby acknowledge the terms and conditions of consultation and treatments at the Modern Balance clinic as stated above and that information provided on this form is accurate, current and will be maintained in accordance with the Health Records Act (2001), National Privacy Principles and the Privacy Act (2001).
- I understand that I should notify my treating practitioners at the Modern Balance clinic prior to undertaking more than one treatment modality on a single day.
- Telehealth is the use of a digital platform via communication technologies, such as a computer, tablet, or mobile phone, for the real-time remote collection, management, and prescription of healthcare information between a client and practitioner.
- When conducting a Telehealth consultation there is a requirement to ensure that the consultation is secure, private, and confidential. A particular Zoom plan has been selected as it provides these important security features. All health records are stored according to the Modern Balance Privacy Policy and relevant State and Federal health record laws.
- Consultations are to be paid for in advance. Supplements are not included in the consultation fee and prescriptions are unique to each individual based on their health concerns, goals and needs.
Practitioner Scope
Madison Dohnt is a University-qualified Naturopath, Nutritionist, Scientist and Educator, specialising in women’s health and hormones. The Practitioner provides women with holistic health services and education, with the goal to help them reach their highest potential through nutrition, exercise, gut health, mental health, and other pillars of natural health; and allowing them to become knowledgeable and intentional about their diet and lifestyle choices. Consultation topics and content will vary depending on Client's personal needs, goals, desired outcomes, priorities and other factors.
The Practitioner offers Services in the form of Health, Nutrition and Mindset Coaching as well as Naturopathic Consultations and Supplement Prescriptions (herein collectively referred to as “Services”). Health Coaching is tailored personal development geared towards helping Client learn about a holistically healthy lifestyle. Nutrition Coaching is assisting Client to learn nutrition fundamentals and utilise these principles to make healthier eating choices. Mindset Coaching is assisting Client to work through limiting beliefs and overcome mindset obstacles to build confidence and reduce stress, in an effort to benefit Client’s goals.
The Practitioner is not a doctor, nurse, dietician, physical therapist, occupational therapist, psychiatrist, psychologist, therapist, personal trainer, counselor, business operations manager, financial analyst, or other agent. The Practitioner may offer her opinion regarding health and/or personal decisions, but it is the responsibility of Client to make the final decision and choose the best option for his/herself. Client also acknowledges that health services cannot come with any guarantees of a perfect outcome. Client hereby acknowledges that Client is solely responsible for the amount and type of progress that Client achieves by implementing techniques and advice provided by Practitioner and remaining compliant with their treatment plan and prescription.
Client Responsibilities
Client accepts and agrees that Client is 100% responsible for his/her results, 100% of the time. Client acknowledges that he/she can optimise their potential results from the Program by adhering to the following:
- Completion of all Program material, including workshops, assignments, exercises and worksheets if applicable;
- Thoughtful and meaningful participation in all calls with Practitioner;
- Utilisation of Practitioner’s feedback;
- Completion of all assigned work, forms, journaling, meditations, material, and research between each Call;
- Committing to the collaboratively created treatment plan;
- Attending each Call at the scheduled date, on time;
- Immediately rescheduling any Calls if necessary in accordance with section 6, and adhering to the rescheduled time and date;
Payment, Rescheduling and Refund Policy
We understand that sometimes, “life happens.” In order to accommodate situations that unexpectedly arise, all requests to reschedule a call must be made no later than 24 hours before the scheduled call. Nothing in this clause is intended to exclude any right or guarantee to which you are entitled under the Australian Consumer Law. All prices are in AUD (Australian Dollars).
Practitioner reserves the right to end the consultation “for cause” at any time, which includes, but is not limited to, the following causes: 1) Client is abusive or harasses Practitioner or other members of Madison Dohnt Pty Ltd; 2) Client payment fails; 3) Client proves to be difficult to work with and/or shows up more than 15 minutes late; 4) for any other legitimate reason. If any of these causes trigger Practitioner to terminate the Agreement, Client is deemed at fault and still liable to pay the entire cost of the consultation.
Confidential Information
Madison Dohnt Pty Ltd takes pride in its proprietary information included in each Program. As such, Client agrees and acknowledges all Confidential Information shared through this Program and by the Practitioner is confidential, proprietary, and belongs exclusively to Madison Dohnt Pty Ltd.
Confidential Information includes, but is not limited to:
- Any systems, sequences, processes or steps shared with Client;
- Any information disclosed in association with this Agreement;
- Any trade secrets in connection with the Program or Madison Dohnt Pty Ltd practices.
Client agrees not to disclose any of Madison Dohnt Pty Ltd and/or Practitioner’s Confidential Information.
Madison Dohnt Pty Ltd also takes seriously its responsibility to protect Client’s personal information and privacy. As such, consider this a mutual non-disclosure agreement. Madison Dohnt Pty Ltd agrees not to disclose any of Client’s personal information. Please see full privacy policy here.
Client agrees to Practitioner sharing general statements about Client’s success and unidentifiable screenshots of messages as social proof and part of its marketing strategy; though this may only involve Client’s first name and is therefore unidentifiable. With Client’s permission only, Client’s photo may be included. Practitioner may also ask if the Client will provide testimonials about the Practitioner and the Program, via video, audio or written testimonials. If provided, the Client grants the Practitioner permission to use the testimonial publicly for marketing as she sees fit. Both parties will keep Confidential Information in the strictest confidence and shall implement the best effort to protect Confidential Information from disclosure, misuses, misappropriation, loss, and theft. As part of the Program, Client information may be used with secure programs and software including: Voxer, Kajabi, Dubsado, Stripe, Google Drive, Simple Clinic, Dispensary Platforms, Nutritional Analysis Software, Gmail and other software where necessary. Practitioner will not disclose any of Client’s personal information to additional third-parties without prior written consent.
Intellectual Property
Madison Dohnt Pty Ltd and its Programs may use free stock photography as part of its design. All stock images used have an irrevocable, non-exclusive copyright license to download, copy, distribute, use and modify the photos for free, including for commercial purposes. Use of said stock photography is permissible under applicable laws without permission from the photographer or attributing the work to the photographer.
This website, content and products contain intellectual property owned by Madison Dohnt Pty Ltd and by third-parties that license some intellectual property to us. This Agreement is intellectual property owned by Madison Dohnt Pty Ltd. Other examples of intellectual property found on our website and within our products and Services include, but are not limited to: trademarks, service marks, layout, logos, business name, design, text, written copy, certain images, podcast recordings, videos, audio files, and all of our paid products (collectively referred to as “Intellectual Property”). You shall not copy, publish, transmit, transfer, sell, create derivative works from, reproduce, or in any way exploit any of the Intellectual Property owned by Madison Dohnt Pty Ltd and the third-parties described within this Section in either whole or part without prior written consent.
Limited License
Madison Dohnt Pty Ltd grants only a limited license to Client to use the Intellectual Property. You acknowledge that any and all products or Services that you download are for your own personal use. You shall not copy, reproduce, transmit, modify, edit, create derivative works from, alter, sell, or share with others any products or parts of the Program without prior written consent or unless provided otherwise, which may incur a fee. Madison Dohnt Pty Ltd grants you a limited, personal, non-exclusive and non-transferable license to use the Program for your personal use.
Client holds a limited license during the Term of this Agreement to use Practitioner’s proprietary program. Client must not misappropriate any of Practitioner’s intellectual property and proprietary information in the following manner:
- Teaching Client’s personal clients any of the information, methods, solutions, or formulae owned by Practitioner and passing it off as their own, e.g. The Trickle Effect, NAPS acronym etc.;
- Copying any of Practitioner’s course material for Client’s business use;
- Copying, publishing, transmitting, transferring, selling, creating derivative works from, reproducing, or in any way exploiting any of the Intellectual Property owned by Practitioner in either whole or part without prior written consent.
Indemnification/ Limitation of Liability
Practitioner provides lifestyle guidance as part of her Program. Client hereby acknowledges that neither Practitioner nor Madison Dohnt Pty Ltd is liable for any injuries that may arise from Client’s personal decisions based off of his/her participation in this program, including but not limited to: a decision to leave a job, leave a relationship, change their living environment, a decision to invest in an opportunity, a decision to start a business, any of Client’s business decisions, any of the Client’s health decisions, any of Client’s financial decisions. Client hereby agrees to indemnify and hold harmless both Practitioner and Madison Dohnt Pty Ltd of any claims that may arise after participation in the Program. Client also agrees that he/she is solely responsible for any decision regarding his/her personal health and indemnifies Practitioner from any liability regarding said decision. Client agrees that Practitioner is not responsible for any physical injuries, diseases, illnesses, or other health conditions that might arise during or after the Program; and agrees to hold Practitioner harmless of any liability regarding any diagnosis of any such injury or health condition. If Client is aware of a pre-existing injury, disease, or health condition, Client hereby acknowledges that he or she has consulted a doctor and made the Practitioner aware.
Miscellaneous
Amendments - We reserve the right to amend this Agreement from time to time. Any amendments must be agreed in writing and executed by both parties.
Headings & Severability - Headings are included for convenience purposes only and shall not affect the construction of this Agreement. If any portion of this Agreement is held to be unenforceable, it shall not affect the remaining portions of the Agreement, which shall remain in full effect. If any portion of this Agreement is held to be unenforceable, then the unenforceable portion shall be construed in compliance with applicable law in a light most favourable to the original intentions of the parties. If the unenforceable portion of the Agreement is found by a competent court of this jurisdiction to be contrary to law, then it shall be changed and interpreted to best reflect the original intentions of the parties, and all other provisions shall remain in full force and effect.
Entire Agreement - This Agreement reflects the entire agreement between the parties. This Agreement trumps any other existing negotiations, communications or Agreements between the parties, whether written, oral, or electronic, and is the full extent of the Agreement between the parties.
All Rights Reserved - All rights not expressly granted in this Agreement are reserved by us.
Governing Law - Madison Dohnt Pty Ltd is located in Queensland, Australia and is subject to the applicable laws governing Queensland, Australia. The governing law for this agreement is the laws of Queensland, Australia.
Arbitration - Any disputes arising under this Agreement shall first be resolved through a binding arbitration.
Execution - This Agreement may be signed digitally. Electronic signatures shall be deemed valid.
Agreement - By signing this Agreement, Client agrees to make all payments. Client hereby acknowledges and agrees to abide by all policies and procedures contained within this document and expresses assent to the terms.