**FREEDOM FUNCTIONAL MEDICINE (FFM) SERVICES POLICIES** Our Mission is to assist you in achieving physical, spiritual, and emotional well-being using a holistic approach to health. Our Philosophy is to educate and empower you to live in optimal wellness.** This approach complements any existing health care program. **FREEDOM FUNCTIONAL MEDICINE (FFM) Intent:** The intent of any and all services offered and/or nutritional protocols or lifestyle recommendations suggested by Dr. Bruns and the FFM team is designed to support the natural physiological & biochemical processes of the human body. The purpose is not to diagnose, treat, prevent or cure any disease. All suggested protocols are from a holistic health perspective. As such, FFM does not act as your primary care physician and you must continue to have a medical PCP and keep them informed of all your healthcare activities. **Memberships** See your separate Membership Agreement for all terms and conditions. Health Coaches may provide coaching and consulting regarding nutrition, supplementation recommendations, lifestyle changes, and health education but does not create a doctor-patient relationship. You must always have a Primary Care Physician that you work with in your hometown even if consulting with one of our MD/PhD/DC/DO/ND practitioners. You agree to keep your doctor informed of all your health and lifestyle changes. Be especially mindful if you take prescriptions and lose weight as many prescribe based on weight. **Consent to Participate in Telemedicine/Telehealth Consultation** By scheduling with Freedom Functional Medicine and by signing this agreement I acknowledge that I am agreeing to participate in telemedicine/telehealth consultation (tele-consults) with the practitioners and/or staff at Freedom Functional Medicine (FFM). I am seeking this tele-consult for my own purposes and not on behalf of any third party. I understand the risks, benefits, limitations and alternatives to tele-consults (including the option to seek a different practitioner for in-person services) and have chosen of my own free will to participate in tele-consults with Freedom Functional Medicine. I understand I am a participant in the decision-making process and I am free to decline any service/treatment/recommendation/suggestion offered by the FFM practitioners at any time. I accept that the FFM practitioner may at any time refer me to a different office if the nature of my consultation is inappropriate for tele-consults. I understand that tele-consults typically involve the use of audio and/or video or other technology between me and the practitioner. Due to the nature of tele-consults, visits are largely educational and rely heavily on the patient history and laboratory findings. Exam and vital findings via video or phone are limited in nature vs an in-person examination.

 

**Cancellations:** We request a minimum of 48 hours advance notice for any cancellation or rescheduling of your appointment. This is a consideration to our practitioners. Short notice or no notice will result in an office visit charge at the regular rate or use of one of your Membership visits. **Payment of Services:** Payment in full is expected at the time of scheduling or through our Membership options. Freedom Functional Medicine receives payment in cash, check, credit and debit card form. There is a $35.00 fee for each returned check. There are no service or membership refunds. You agree that your credit card on file will be automatically charged for any Freedom Functional Medicine invoice generated such as your visit fee or if a supplement order or lab order is requested. You also authorize Freedom Functional Medicine to automatically charge your credit card for any missed appointments or late cancellations of less than 48 hours in advance at the full service fee. There is no additional charge for rescheduling or canceling appointments more than 48 hours in advance. Keep in mind, membership visits must be used each month, they do not roll over. See your Membership Agreement for full details. You are also responsible for any chargeback fees if for some reason your credit card is declined. This authorization is part of your patient records and will be treated with privacy, confidentiality and respect. **Additional time charge:** If a visit goes over the scheduled time (ex. 1 hour) then there will be an additional visit charge in 15 minute increments at the prorated rate. Your credit card on file will be charged after the visit is completed. **Refunds:** Supplements and Lab work is purchased through outside vendors and FFM can not issue any refunds, please only purchase items you intend to use. There are no service or membership refunds. **Primary Care Physician (PCP):** Dr. Havalyn Bruns DC, FMACP is a Doctor of Chiropractic and specializes in functional medicine and nutrition operating within the scope of her license. Dr. Bruns is not a medical doctor, does not act as a primary care physician and is not on call, nor are any Freedom Functional Medicine practitioners regardless of license type including MD/DO/DC/ND/PhD/NP. Please maintain a positive, working relationship with your medical doctor, keep him/her informed of your healing activities and continue your regular medical care and check-ups. This applies to all providers/practitioners with Freedom Functional Medicine.

 

Dr. Havalyn Bruns, DC, FMACP or any of the practitioners/staff/employees/contractors are not liable for any illness or injury. **Photo release, Social Media release, Website and Marketing release** You agree to authorize Freedom Functional Medicine, A Georgia Family Chiropractic Corporation and Dr. Havalyn Bruns, DC, FMACP use of any public reviews (ex. Google, Yelp, Facebook, etc) that you submit or a review emailed to us. These reviews may be used for marketing activities and other online promotions via social media, websites and all printed or digital publications and media in perpetuity. You acknowledge that participation is voluntary, there is no financial compensation and this includes photos, graphics and testimonials. You release Freedom Functional Medicine and Dr. Havalyn Bruns, DC, FMACP of any liability or claims by yourself or any third party related to the use of photographs, graphics or testimonials in printed or digital media. **Updates to FFM Policies** All current updates to our Policies will be immediately applicable to you & all previous signers and posted on the Freedom Functional Medicine website and in our software. You may view them there or request an updated copy emailed to you at any time. **Stopping Medication:** Freedom Functional Medicine practitioners will **NOT** take you off any medication, which can only be done with your prescribing physician. If your goal is to decrease your need for medication, we can suggest a protocol to encourage health and then you may work with your medical doctor (MD) to monitor your progress and see if you are able to lower or eliminate your medication dosage over time. Keep your MD informed. **Emergencies:** In case of an emergency, call your PCP, visit your local urgent care or call 911.