Please submit the New Client Agreement prior to initial consultation

New Client Agreement

By submitting this form I agree to the terms and conditions of this nutrition practice: 

 Payment is due prior the the consultation. Cancellations require 24 hours notice. If I cancel less than 24 hours prior to the appointment: a consultation in my package will be forfeited, or I will pay for the consultation in full when not invested in a package. Nutrition packages expire one year from the date of purchase. This practice does not participate with any insurance plans. I read HIPAA notice below.

The Healthy Ivy-Meredith Liss Nutrition

(646) 322-6521