LACTATION COUNSELOR AGREEMENT, DISCLOSURE & POLICIES
Please read every portion of this document before proceeding with the lactation counselor appointment.
You, the client, agree to all terms, disclosures, and policies outlined in this document upon signing the Client Intake Form section titled “LACTATION COUNSELOR AGREEMENT,
DISCLOSURE & POLICIES DOCUMENT”
Failure to agree to all terms, disclosures and policies outlined in this document will result in cancellation of the appointment; client will not be eligible to receive a refund unless written communication is made at least 24 hours before the scheduled appointment.
Your open communication is vital in tailoring our approach to meet your unique needs. Please ensure to provide honest and accurate information about your breastfeeding history, feeding routines, challenges, and any relevant medical or health-related details; that way, I am able to create a comprehensive care plan that addresses your specific circumstances.
It is the client’s responsibility to communicate any concerns about the care plan and request other recommendations during the counseling session.
To ensure that each client receives the dedicated support they need, it's important to stay within the allotted time for your scheduled appointment. If you have extensive concerns or additional topics to discuss, we can consider scheduling an additional session to accommodate your needs. I appreciate your understanding and cooperation in respecting the scheduled session duration. Your punctuality and adherence to the session time are greatly valued and contribute to a smooth counseling experience for all clients.
After our counseling session, I will review the information discussed and any additional details you've shared. I will carefully consider your unique situation, goals, and challenges to create a tailored care plan that addresses your specific needs. Once your care plan is ready, you can expect to receive it within 24 hours of our initial counseling session. This turnaround time allows me to gather all of the information and resources together.
Non-Medical & Referral Disclosure
The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. The Titty Bar Mama makes no representation and assumes no responsibility for the accuracy of information contained on or available through this website, and such information is subject to change without notice. All information provided on the website is general information provided for educational purposes. You are encouraged to confirm any information obtained from or through this website with other sources, and review all information regarding any medical condition or treatment with your child’s physician. Never disregard professional medical advice or delay medical treatment because of something you have read on this website.
I am not a medical doctor; while I have received specialized training and certification as a lactation counselor, I do not possess the qualifications to diagnose medical conditions or provide medical treatment. If I encounter issues that require medical evaluation or intervention, I will recommend that you consult with a healthcare professional, such as an IBCLC, pediatrician, or other qualified healthcare provider. You and your baby's health and well-being are of utmost importance, and I will always prioritize your safety and best interests.
By participating in our lactation counseling sessions, you acknowledge that you understand the limitations of my role as a certified lactation counselor. You also agree to take responsibility for seeking appropriate medical advice or care when necessary. Breastfeeding can be a dynamic process, and you may encounter different challenges along the way. I will do my best to provide you with information and resources to help you make informed choices that are right for you and your baby.
Consent for Record Keeping
Chrissie Demarais, The Titty Bar Mama, may keep records of counseling sessions for reference and to better support your needs. By participating in our sessions, you consent to the collection and storage of such records. Rest assured that your information will be kept confidential and in compliance with all applicable data privacy laws.
Your privacy and the security of your information are of utmost importance to me. To maintain maximum privacy and security, our interactions will be limited to the following:
Email: You can reach me at firstname.lastname@example.org for any non-urgent inquiries or to schedule appointments. Please use this email for general correspondence and questions.
Phone: For text appointments, my number will be provided.
Secure Video Calls: We can conduct video counseling sessions through FaceTime or Webex (subject to change). This option provides a confidential and secure environment for our virtual meetings.
Confidentiality and Data Privacy
Chrissie Demarais, The Titty Bar Mama, is committed to safeguarding your privacy and complying with all relevant data privacy regulations. Any personal information you share with me during our sessions will remain confidential, and I will not disclose it to third parties without your explicit, written consent.
Rescheduling & No-Show
I understand that life can be unpredictable and circumstances may arise that require you to reschedule your lactation appointment. I kindly request that clients provide 24 hours notice if you need to reschedule your appointment. This allows me to offer the appointment slot to another client who requires lactation services.
No-show appointments and cancellations will not be eligible for a refund or reschedule.
In certain circumstances, such as emergencies or unforeseen medical situations, I understand that cancellations may be unavoidable. I am committed to working with you and will review cancellations on a case-by-case basis to determine eligibility for a refund or reschedule. If you believe that your cancellation falls under exceptional circumstances, please contact me as soon as possible to discuss the situation.
Certified lactation professionals are NOT a medical doctors. All content and information on this website are for educational purposes only, and does not constitute medical advice. Although we strive to provide accurate lactation information, the information presented here is not a substitute for any kind of medical advice, and you should not rely solely on this information.
You acknowledge that everything on this website, including all texts, photographs, images, illustrations, graphics, and all other material is for informational purposes only and is not medical, nutritional, fitness, or mental health advice. Nothing on this website is a substitute for professional medical or mental health advice, diagnosis, or treatment for any medical conditions. Always seek the advice of a physician or other qualified health providers with any questions you may have regarding your medical or mental health condition. Please consult with that provider prior to making any health-related changes for yourself or others. You are solely responsible for the effects of any changes you make to your lifestyle after reading this disclaimer. If you rely on any information provided by our consultation, you do so at your own risk, and you acknowledge that the operator of this website bears no responsibility for any actions you take after our appointment or reading our website. The Titty Bar Mama is not liable for the consequences of any of those actions.
The Titty Bar Mama