Please note that completing this screening process enables us to review your application for COACHED by Beth. Providing this information does not guarantee acceptance. COACHED by Beth reserves the right to determine eligibility to participate. Please note that all photographs or other images submitted will be treated confidentially and will not be used, disclosed, or shared in any way other than by COACHED by Beth without your permission. I understand and acknowledge that COACHED by Beth is an approach to health and weight loss-focused wellness, nutrition and fitness for people in good health, and not a medical program, and that Coach Beth is a certified health coach but NOT a licensed health professionals and has no healthcare training. I understand that COACHED by Beth focuses only on eating and weight loss and maintenance goals and not other personal issues. I agree to seek the clearance of a physician or qualified medical professional to manage my health and determine if COACHED by Beth and its components are appropriate for me. I understand that I should not apply for COACHED by Beth if I have a medical condition that would limit my ability to restrict my eating or to exercise vigorously on a daily basis. I understand that my success participating in COACHED by Beth depends upon my commitment. I am ready, willing, and able to devote the time needed to complete and fulfill the Program. I agree to responsive and cooperate in meeting the ongoing requirements of participation in COACHED by Beth in a timely manner. I understand that I should not apply for COACHED by Beth if I know or suspect that I may be pregnant, have an eating disorder or related mental or behavioral health problem requiring management under the care of health professional, diabetes, or any other unmanaged physical, psychological, or emotional condition involving purging, binging, or other activity that would present any risk form vigorous exercise or diet. I understand that COACHED by Beth reserves the right to require a medical clearance letter as a condition of participation. I understand that COACHED by Beth takes no responsibility for managing my health and is not serving as my doctor, dietician, or other health professional role. I understand and acknowledge that COACHED by Beth enforces a strict no-refund policy. This policy is in place to increase client accountability, including fairness and respect for other clients. If a condition occurs where a client is unable to continue due to a medical condition after making a payment COACHED by Beth will not return payment but coaching sessions will continue once client is medically cleared. I understand and hereby agree, that should I engage in this program in exchange for valid consideration, I acknowledge and agree that I will be provided with information which is to be kept confidential. As such, I agree not to share, in any manner, the details of my relationship with my coach and/or the plan that is created for my specific situation. The method, system and requirements comprise “confidential information” belonging to COACHED by Beth. Such information is the proprietary information of COACHED by Beth and the means upon which COACHED by Beth is able to complete its obligations. Participant agrees to keep such information confidential. Sharing such information with any other party, in any manner, is detrimental to COACHED by Beth. Dissemination of confidential information to any other party who discloses the same is the responsibility of the Participant.