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I, authorize Priti Gaglani's HEALTH RESERVOIR and understand the programs are educational, to help me in my weight reduction program, reduction in unhealthy habits, detoxification, disease control etc. using a regular exercise program, nutrition or behavior modification techniques. Other treatment options may include a very low calorie diet or a protein supplemented diet.
I understand that any medical treatment may involve risks as well as the proposed benefits. I have also understood that there may be risks that are not associated with increasing severities of pre-existing diseases. This program might include gastrointestinal distress, dizziness, psychological problems, low blood pressure, heartburn, and heart irregularities. There are other medical problems such as high blood pressure or heart disease associated with short caloric intake which can lead to anemia, muscle loss, increased risk of heart attacks, strokes and other diseases associated with aging including high blood pressure, diabetes, heart attack and heart disease. Symptoms of the illness, including hair loss, and skin dryness, acne and such other diseases, which can be avoided with aging.
I understand that much of the success of the program will depend on my efforts and that there is no easy way to achieve anything in life. There may be regular changes in my eating habits and permanent changes in behavior needed successfully to maintain weight.
I have read and fully understand the consent form and realize I should not sign this form if all statements have not been explained to me. Questions also have been raised and my consent given to this form. I have been explained and have been given all the risks involved in my weight loss.
I give my consent to use my Written Feedback, before and after photographs in their blog / website / social official communication.
WOMEN ONLY:
I have been informed that I should NOT get pregnant while on this Health Plan and should stop immediately if I do get pregnant. I should consult with the doctor and nutritionist on this matter. I should NOT be pregnant or lactating while on this program. Priti Gaglani's HEALTH RESERVOIR Health Plan is meant only for healthy women. The program is not meant for any woman who is pregnant or planning to get pregnant while starting Health Plan drafted by Priti Gaglani's HEALTH RESERVOIR.
