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General Health Information

General Health Information - Pre Appointment Form

In order for Nutrition For Women to support you, please provide the following information:

(Please add what you know. Do not worry if you are not sure)

About your menstrual cycle
Do you smoke?
I give consent for Nutrition for Women to contact me regarding my nutrition support including sending relevant resources:

Use of Personal Data

Notes will be taken during the session. A copy of your notes will be sent to you after the consultation. You are responsible for letting Nutrition For Women know within 48 hours of the appointment if there are any inaccuracies in the notes so that they can be rectified.

Your case may be discussed with another nutritionist registered with the Association for Nutrition should support or supervision be required but no identifiable details will be given. Only in cases of safeguarding, or other situations under UK law, will confidential information be shared with third parties.

Your data will be held by Nutrition For Women in line with General Data Protection Regulations as set out in the policies and statements available here

Limitations of the service

In certain circumstances, once the service has commenced, information may be revealed which means that the Registered Nutritionist is not qualified to support the client further. If this happens the client will be informed within 5 days of the consultation and will be given details of other professionals who may be able to help.

Every step will be taken to ensure this comes to light before sessions commence but if sessions have already commenced, the client is required to pay for the sessions already delivered.

The Registered Nutritionist accepts no liability for the services provided by other professionals.                                                  


Payment for the service(s) will be made when the appointment is made.


If the client cancels a consultation within 48 hours of the appointment, or fails to attend, the client will have to pay the full amount for the session.

If more than 48 hours’ notice is given by the client, or the Registered Nutritionist cancels a consultation, a refund will be issued or the appointment time changed without additional charges.


I, Nutrition For Women, always use reasonable efforts to ensure that my provision of the Services is trouble-free.  If, however, there is a problem with the Services, I request that You inform me as soon as is reasonably possible. A full copy of my complaints policy available here


Governing Law and Jurisdiction

The Agreement, and the relationship between You and me, Nutrition For Women, (whether contractual or otherwise) shall be governed by, and construed in accordance with the law of England & Wales.

Any dispute, controversy, proceedings or claim between You and me, Nutrition For Women, relating to the Agreement, or the relationship between You and Us (whether contractual or otherwise) shall be subject to the jurisdiction of the courts of England & Wales. 



I agree to the above terms and conditions and confirm that, to the best of my knowledge, the information given in this form is accurate and complete.

Thanks for completing the form. We'll be in touch soon.

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