INFORMED CONSENT FOR NUTRITION COUNSELLING

Darla Paola Maldonado Barsse, NNCP
Nutritionist | Natural Nutrition Clinical Practitioner (CANNP Member)
507-8 Wilsonview Ave, Guelph, Ontario N1G 1V3, Canada
info@darlabarsse.com | https://darlabarsse.com
Effective October 22, 2026 | Version 1.0

1. Practitioner identity and scope

I understand that Darla Paola Maldonado Barsse offers online nutrition counselling and education in her capacity as a Nutritionist and an active Natural Nutrition Clinical Practitioner (NNCP) member of the Canadian Association of Natural Nutrition Practitioners (CANNP). She is not a Registered Dietitian (RD), is not registered with the College of Dietitians of Ontario, and is not presenting herself as a physician or another provincially regulated healthcare professional. Her professional association membership does not amount to registration with a provincial regulatory college.

2. Nature of the service

Services may include dietary intake review, nutrition education, meal-planning support, lifestyle and habit discussions, reviewing food diaries and non-diagnostic measurements, setting realistic goals and follow-up visits. Advice is individualized to information I share but does not guarantee a particular result. Weight, energy, digestion and other outcomes vary between individuals.

3. Important professional limitations

I understand that nutrition counselling is not medical diagnosis, medical treatment, emergency care, psychotherapy or a substitute for care by a physician or Registered Dietitian when such care is indicated. Darla does not diagnose, prescribe medications, or instruct me to stop or change prescribed treatment. She may suggest nutritional supplements within her competence, but I should disclose medications, allergies and medical conditions and consult my appropriate regulated healthcare professional before taking supplements if there is a safety concern, interaction or pregnancy-related issue. She may decline or discontinue service and recommend a referral when my needs are beyond her competence or lawful scope.

4. Benefits, limitations and foreseeable risks

Potential benefits include greater understanding of nutrition and support with practical food choices. Foreseeable risks include misunderstandings of recommendations, food-allergy exposures if information is incomplete, unsuitable changes in intake if advice is followed incorrectly, supplement interactions, emotional discomfort discussing body image or eating, and technological or confidentiality risks associated with online care. I may ask questions and decline any recommendation. No outcome is guaranteed.

5. My participation and safety information

I agree to provide accurate information to the best of my knowledge about relevant health conditions, allergies, current medications and supplements, pregnancy, dietary restrictions and important changes. I understand that incomplete information can affect the safety and usefulness of the consultation. I am encouraged to seek urgent medical assistance for emergencies, serious symptoms or acute deterioration; this online service is not an emergency service.

6. Online consultations, records and communications

I consent to receiving services through online video and secure practice systems, understanding that connectivity problems and privacy risks can occur. Sessions are not recorded by the practice. Consultation notes, intake data, plans, progress measures, receipts and consent records are maintained as part of my client record in accordance with the Privacy Policy. I understand that email and WhatsApp are available for routine communication but may not be appropriate channels for detailed sensitive medical records. I will use a reasonably private location and protect access to my login and appointment link.

7. Minors and decision-making capacity

Where the service is for a minor, the practitioner must establish who is legally able to consent to the particular service and what parent, guardian or substitute decision-maker involvement is appropriate. A capable minor may have rights concerning consent and confidentiality. A parent or guardian who books for a minor confirms that they have authority to act where such authority is legally required, without overriding the rights of a capable minor.

8. Voluntary consent and withdrawal

I have been informed about the nature, purpose, expected benefits, limitations and foreseeable risks of these services. I can ask questions before or during my consultation. I voluntarily consent to nutrition counselling with Darla Paola Maldonado Barsse. I can decline recommendations or withdraw consent to future services, subject to applicable payment, recordkeeping and legal obligations. The fact that my information must lawfully be retained does not mean I must continue receiving services.

9. Electronic acknowledgement

By actively selecting the Informed Consent checkbox in the booking process, I confirm that this document was made available to me, I understand its essential information, and I agree to receive the services described. My booking system records the document version, my acceptance, date and time, and the associated booking. The electronic acceptance is evidence of consent but does not replace my ability to ask questions or the practitioner's obligation to obtain appropriate ongoing consent.