Privacy Policy was last modified on May 11, 2022. As a certified nutrition consultant, I, Stephanie Wilkins, collect information from said clients for the sole purpose of developing personalized healthy living plans for the said client. All information collected is confidential between consultant and client. No paper copies of this information are kept. Information on intake form contains client’s first name only. No financial or insurance information is requested or listed on any form. Information such as age, weight, sex, medications and medical diagnosis are input into a computer program utilizing an assigned number instead of a legal name to maintain privacy for the said client. This program calculates personalized reporting for the said client. These records are kept electronically under the said client’s assigned number for 1 year and then deleted. Client may access his or her plan information from the practice for up to one year with their assigned client number.Please sign in agreement to the above privacy policy related to your personal information that you have released into our care.I {patient name} agree to the terms of the above privacy policy.(Required)Provide your signature here indicating you are in agreement.Signature(Required)Patient or ClientDate(Required) MM slash DD slash YYYY Email(Required) Δ
