Terms and Conditions

USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION (PHI)

We are committed to protecting the confidentiality and security of your Protected Health Information (“PHI”) in accordance with applicable laws, including the Health Insurance Portability and Accountability Act (HIPAA). Your PHI may be used or disclosed for purposes related to your care and services, including scheduling, conducting, and reviewing your health assessments, as well as for payment and operational needs such as billing, quality improvement, staff training, and compliance. We will not use or disclose your PHI for any other purpose without your written authorization, except as required or permitted by law (for example, public health reporting or responding to legal obligations). You have the right to request restrictions, access, or amendments to your PHI as outlined in our Privacy Practices.

Consent & Waiver Agreement

RECORDS REVIEW FOR RESEARCH

I grant DexaFit Nashua and/or DexaFit, Inc. permission to utilize or review my de-identified records for research purposes, and to assess my eligibility for approved clinical studies, allowing them to contact me if I qualify as a research candidate.

SCOPE OF SERVICES

DexaFit collects and transmits data only; we do not diagnose, treat, or prescribe. Any interpretation of your results must be performed by a licensed healthcare professional of your choice

In appreciation of the comprehensive services offered by DexaFit Nashua and/or DexaFit, Inc., I embrace these offerings with confidence in the commitment to client well-being. I understand the nature of each service and acknowledge the terms outlined herein.

DEXA Scan

I provide consent to DexaFit Nashua and/or DexaFit, Inc. for the use of their DXA scanner to conduct body composition and/or bone densitometry scans, acknowledging the use of low-dose x-rays in the technology.

DEXA body composition results are subject to variability due to a number of factors. While DEXA is a highly accurate method for estimating body fat, lean mass, and bone density, results are not absolute and should be interpreted as estimates.

Specifically, regional body composition values (arms, legs, trunk, etc.) may vary between scans due to:

  • Slight changes in body positioning during the scan,

  • Variations in Region of Interest (ROI) placement by the technician or software,

  • Hydration status, recent food intake, and other biological factors,

  • Differences in machine calibration or environmental conditions.

I understand that DexaFit Nashua and/or DexaFit, Inc. does not provide diagnostic medical advice, and does not guarantee the accuracy, completeness, or clinical interpretation of DXA scan data. I acknowledge that interpretation of scan data is solely my responsibility and should be done in consultation with a licensed healthcare provider. I waive any liability claims related to the accuracy or interpretation of data provided.

I acknowledge that DXA body composition results, including measurements of fat mass, lean mass, and bone density, may vary due to physiological factors, hydration, positioning, and technical margin of error. I understand that variations are considered normal and acceptable in such scans. I agree that DexaFit is not responsible for any consequences resulting from such variations, and I waive any claim to refunds or legal action based on these results.

RMR (Resting Metabolic Rate) Test

DexaFit Nashua and/or DexaFit, Inc. introduces Resting Metabolic Rate testing services, a method for determining the caloric requirements of the body at rest. I willingly provide consent for the administration of this test, recognizing its role in tailoring wellness strategies. I acknowledge that DexaFit is not liable for any inaccuracies in the RMR test reports or any consequences resulting from following advice based on these reports.

The attainment of nutritional objectives is contingent upon the client's dedication and adherence to recommendations. While DexaFit Nashua and/or DexaFit, Inc. is committed to delivering professional guidance, individual outcomes may vary based on personal choices and other contributing factors.

It is explicitly acknowledged that DexaFit Nashua and/or DexaFit, Inc. bears no liability for outcomes or consequences resulting from nutrition counseling sessions. The client assumes full responsibility for achieving desired nutritional outcomes.

VO2 Max Test

  1. Purpose and Explanation of the Test

    • You will perform a graded exercise test on a motor-driven treadmill or stationary bike. The exercise intensity will begin at a low level and advance in stages, depending on your fitness level. The test may be stopped at any time due to signs of fatigue, changes in heart rate or blood pressure, or any symptoms you may experience. You may stop the test at any time due to feelings of fatigue or discomfort.

  2. Attendant Risks and Discomforts

    • As with any exercise, there exists the possibility of certain changes occurring during the test, including abnormal blood pressure, fainting, irregular, fast, or slow heart rhythm, and, in rare instances, heart attack, stroke, or death. Please note that there will NOT be a physician present on-site.

    • You and your own Doctor should evaluate the information you possess about your health status or previous experience with exercise-related or heart-related symptoms (such as shortness of breath with low-level physical activity, pain, pressure, tightness, or heaviness in the chest, neck, jaw, back, and/or arms) that may affect the safety of your test. Your prompt reporting of these and any other unusual feelings during the test is of great importance. You are responsible for consulting with your own doctors before taking the test.

  3. Inquiries

    • Any questions about the procedures used in the exercise test or the results of your test are encouraged. If you have any concerns or questions, feel free to ask via email at nashua@dexafit.com prior to the test.

  4. Voluntary Participation & Assumption of Risk
    I acknowledge that I am voluntarily undertaking a graded exercise (“VO₂ max”) test conducted by DexaFit Nashua LLC and/or DexaFit, Inc. (“DexaFit”). I understand the test involves progressively strenuous activity on a motor‑driven treadmill or stationary bike without a physician on site and that inherent risks include, but are not limited to:

    • slips, trips, falls, or ejection from the treadmill/bike;

    • muscle strains, sprains, ligament or tendon tears, bone fractures, impact injuries, and bruising;

    • dizziness, fainting, dehydration, heat illness, nausea, or vomiting;

    • abnormal blood‑pressure responses, arrhythmias, angina, heart attack, stroke, cardiac arrest, or sudden death; and

    • any aggravation of pre‑existing medical conditions.

    I freely and knowingly assume all such risks, whether foreseeable or unforeseeable, that may arise from or be connected in any way to my participation.

  5. Inquiries
    Any questions about the procedures used in the exercise test or the results of your test are encouraged. If you have any concerns or questions, feel free to ask via email at nashua@dexafit.com prior to the test.

  6. Release of Liability & Covenant Not to Sue
    To the fullest extent permitted by applicable law, I hereby waive, release, discharge, and forever covenant not to sue DexaFit, its owners, directors, officers, employees, contractors, agents, successors, and assigns (collectively, the “Released Parties”) from any and all claims, demands, actions, causes of action, damages, losses, costs, or expenses—including attorneys’ fees—of any nature whatsoever (collectively, “Claims”) arising out of or related to:

    • my participation in the VO₂ max test;

    • any injury (physical, psychological, or otherwise), illness, disability, property damage, or death sustained during or after the test; or

    • the ordinary negligence, acts, or omissions of any of the Released Parties.

    This waiver expressly covers—but is not limited to—Claims arising from falling off the treadmill or bike, equipment failure, misadjustment or misuse of equipment, inadequate instructions or supervision, emergency‑response delays, or inaccurate test results or interpretations.

  7. Indemnification
    I agree to indemnify and hold harmless the Released Parties from any Claim brought against them by me, my estate, my heirs, or any third party arising from my participation, except to the extent caused by the Released Parties’ gross negligence or willful misconduct.

  8. Governing Law & Severability
    This Addendum is governed by the laws of the State of New Hampshire. If any portion is held invalid, the remainder shall remain in full force and effect.

  9. I HAVE READ, UNDERSTAND, AND VOLUNTARILY AGREE TO THESE TERMS.
    I certify that I am at least 18 years old (or have obtained a parent/guardian signature) and that I have consulted my own medical professional regarding my suitability for this test. I hereby consent to engage in an exercise test to determine my exercise capacity. My permission to perform this test is given voluntarily. I understand that I may stop the test at any point if I so desire. I have read this form and understand the test procedures I will perform and the attendant risks and discomforts. I understand that there will NOT be a supervising physician onsite. Knowing these risks and discomforts, and having had an opportunity to ask questions that have been answered, I consent to participate in the test.

FINANCIAL RESPONSIBILITY

I hereby acknowledge and assume full financial responsibility for all charges related to the services provided to myself, my family members, and/or my responsible parties at DexaFit Nashua. I understand and agree that all payments are non-refundable, and I explicitly waive any right to dispute transactions.

In the event of a cancellation within a 24-hour period preceding the scheduled appointment, I acknowledge that no refunds will be issued. Additionally, I commit to paying a $50 rescheduling fee for any changes made within a 24-hour timeframe from the scheduled appointment. There will be no refund issued for no-show appointments. Furthermore, no refund will be issued if any test part of a bundle is rescheduled and subsequently canceled. I agree and acknowledge that appointments made for special events can not be rescheduled to another day.

Furthermore, I recognize that should I choose to reschedule within 24 hours of the appointment and subsequently cancel, I am obligated to pay the complete value of the service along with an additional rebooking fee.

Subscription-Based Services: For subscription-based plans, clients commit to a 4-week billing cycle upon enrollment. All sales for the 4-week subscription cycle are final, and no refunds will be accepted once the billing period commences. In the event of a cancellation within the 4-week billing period, the client is not entitled to a refund, and the full financial obligation for the current cycle remains in effect. The subscription will renew unless canceled by the client. It is acknowledged that this is the client's responsibility and not that of DexaFit Nashua and/or DexaFit, Inc.

I acknowledge and understand eligibility for HSA/FSA reimbursement for all programs is program-specific and that I must contact my HSA/FSA plan administrator for specific guidelines and procedures for my specific plan terms.

By accepting these terms, I affirm my dedication to meeting the financial obligations associated with the services provided.

WAIVER AND AGREEMENT

  1. I release all representatives of DexaFit Nashua and/or DexaFit, Inc. from any responsibility or liability for injury or damage to myself, including those caused by the negligent acts or omissions of those mentioned or others acting on their behalf, arising out of or connected with my participation in services, activities, or programs of DexaFit Nashua and/or DexaFit, Inc.

  2. I am voluntarily participating in the DexaFit Nashua and/or DexaFit, Inc DXA scan service and/or other services, including RMR and VO2max Metabolic Analysis, Training Programs, and nutritional/meal planning consultation, and all other services performed by DexaFit Nashua. I expressly assume all risks of injury and death resulting from participation in the aforementioned services.

  3. I declare myself to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness that disqualifies me from receiving a DXA scan from DexaFit Nashua and/or DexaFit, Inc. I acknowledge that I have permission to participate or have decided to participate in these services without the approval of my physician, assuming all responsibility for my participation. I also certify that I am not pregnant or trying to become pregnant.

  4. I take full responsibility for any action taken by me after my visit to DexaFit Nashua and/or DexaFit, Inc. I do not hold any representatives of DexaFit Nashua or DexaFit, Inc responsible or liable for any adverse effects or complications arising from the services or opinions offered by them.

  5. Confidentiality: Information based on the observations made during the DXA scan, VO2max, or RMR analysis, and subsequent reports are treated as privileged and confidential. However, it may be used for statistical or scientific purposes while retaining your right to privacy.

  6. I understand that DexaFit Nashua and/or DexaFit, Inc does not diagnose or interpret the DXA results, and that any further review or analysis of the report is between the individual and their primary care physician.

CLIENT HIPAA CONSENT FORM

I understand that I have certain rights to privacy regarding my protected health information under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). By signing this consent, I authorize DexaFit Nashua and/or DexaFit, Inc to use and disclose my protected health information to carry out:

  • Treatment (including direct or indirect treatment by other healthcare providers involved in my treatment)

  • Obtaining payment from third-party payers (e.g. my insurance company)

  • The day-to-day operations of DexaFit Nashua practice.

I understand that I have the right to request restrictions on how my protected health information is used and disclosed to carry out treatment, payment, and health care operations, but that DexaFit is not required to agree to these requested restrictions. If agreed, DexaFit is bound to comply with these restrictions.

I may revoke this consent in writing at any time, but any use or disclosure before the date of revocation is not affected.

AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION

I authorize DexaFit Nashua and/or DexaFit, Inc to forward the health and fitness information resulting from their services to me or any parties authorized by me through email, fax, mail, or the private login page on the DexaFit website. This Authorization is subject to revocation/withdrawal in writing by me to DexaFit Nashua, except for actions already taken to release this information. This Authorization shall remain valid unless revoked, and DexaFit Nashua and/or DexaFit, Inc will not forward my health and fitness information if I do not consent to this Authorization.

I attest that I am NOT pregnant and/or over 350 pounds and have read and agreed to the above, consenting to participate in the services rendered by DexaFit Nashua.