Global Nutrition – New Client Intake Form

All fields marked required must be completed before your appointment. Incomplete forms may delay or reschedule your visit.

All medications, supplements, doctors, illnesses, and hormone changes MUST be listed.

Client Policies, Consent & Agreement

By submitting this form, I acknowledge and agree to the following:

Appointments & Packages

  • All appointments/packages are non-transferable and must be used by the person who purchased them.

  • One person per visit; appointments may not be shared.

  • Packages (3, 5, 12 visits) are one visit per month; unused visits are forfeited and do not roll over.

Boost Appointments

  • Must be used within 6 months; unused visits do not roll over.

Email Support

  • Available only between scheduled visits for brief clarifications.

  • New or ongoing concerns require a scheduled appointment.

  • Boost appointments get 14 days email support; after that, questions require an appointment.

Consent & Disclaimer

  • I understand these services are educational, not medical treatment or diagnosis.

  • I am responsible for my own health decisions.

  • Carla Buscaglia is not a licensed medical doctor.

Waiver of Liability

  • I release Carla Buscaglia and Global Nutrition from any liability related to services or recommendations.

Cancellation Policy

  • 48-hour notice required for cancellations or full service fee applies

  • No returns on services or supplements

Contact Information

Global Nutrition does not text
Email: myplan@globalnutrition.us
Phone: 585-310-7860