CONSENT FOR SERVICES

Steamboat Lactation & Sleep LLCSteamboat Springs, Colorado 80487Phone: 970-439-2703Email: SteamboatLactationSleep@gmail.comwww.SteamboatLactationSleep.com

By signing below, I acknowledge that I have read, understood, and agree to the following terms and conditions for services provided by Steamboat Lactation & Sleep ("Provider"):

1. Nature of Services

  1. Educational and Coaching Support. The services provided by Steamboat Lactation & Sleep are educational, informational, and coaching in nature. Services may include lactation support, breastfeeding education, infant and child sleep coaching, guidance on feeding and sleep routines, and related parenting support.

  2. Not Medical Diagnosis or Treatment. Provider is a Doctor of Pharmacy (PharmD), Certified Lactation Counselor (CLC), and Certified Pediatric Sleep Consultant. However, services provided through Steamboat Lactation & Sleep are limited to lactation education, feeding support, infant and child sleep education, coaching, and related supportive services. These services do not constitute medical diagnosis, medical treatment, therapy, clinical care, or emergency medical services. Provider does not diagnose medical conditions, prescribe medications, manage medications, or replace care provided by a physician or other qualified healthcare professional. I understand that I should seek evaluation and treatment from my healthcare provider or my child's healthcare provider for medical concerns, including illness, feeding complications, growth concerns, developmental concerns, or sleep disorders.

  3. Lactation Support Scope. Lactation support services may include education on breastfeeding techniques, positioning, latch assessment, pumping guidance, and general support. Provider holds the credential of Certified Lactation Counselor (CLC) and is not an International Board Certified Lactation Consultant (IBCLC).

  4. Sleep Coaching Scope. Sleep coaching services provide education and support regarding infant and child sleep patterns, safe sleep practices, sleep hygiene, and age-appropriate sleep strategies. Sleep coaching does not diagnose or treat sleep disorders or other medical or behavioral conditions.

2. Medical Care and Pediatric Oversight

  1. Pediatric Care Required. My child must be under the active care of a licensed pediatrician or other qualified healthcare provider. I agree to maintain regular well-child visits and follow my child's healthcare provider's medical advice.

  2. Medical Consultation and Referrals. Provider may recommend that I consult with my child's healthcare provider or other medical professionals regarding feeding difficulties, growth concerns, medical conditions, sleep disorders, developmental delays, or other health-related issues. I agree to seek appropriate medical care when recommended or when I have concerns.

  3. No Replacement for Medical Advice. The services provided are not a substitute for professional medical advice, diagnosis, or treatment. I will not rely solely on Provider's services for medical decisions and will consult my child's healthcare provider for all medical questions and concerns.

  4. Emergency Situations. Provider does not provide emergency services. In the event of a medical emergency involving my child or myself, I will immediately call 911 or seek emergency medical care. Examples of emergencies include difficulty breathing, choking, severe dehydration, unresponsiveness, seizures, or any life-threatening condition.

3. Safe Sleep Practices

  1. Safe Sleep Education. Provider will provide education consistent with safe sleep recommendations from the American Academy of Pediatrics (AAP), including placing infants on their backs to sleep, using a firm sleep surface, room-sharing without bed-sharing, and avoiding soft bedding and hazards in the sleep environment.

  2. Parent Responsibility. I am solely responsible for implementing safe sleep practices and making all decisions regarding my child's sleep environment and routines. I agree to follow current safe sleep guidelines and consult my pediatrician with any questions or concerns.

  3. Individualized Decisions. Provider may discuss various sleep approaches and strategies, but I am responsible for choosing and implementing methods that align with my family's values, my child's individual needs, and my pediatrician's recommendations.

4. Informed Decision-Making and Parental Autonomy

  1. Educational Information. Provider offers evidence-based education, guidance, and support to help me make informed decisions about feeding and sleep. All final decisions regarding my child's care rest solely with me as the parent/guardian.

  2. No Guarantees. Provider makes no guarantees or warranties regarding specific outcomes, results, or timelines. Every child is unique, and results may vary based on individual circumstances, consistency of implementation, developmental factors, and other variables beyond Provider's control.

5. Service Delivery and Communication

  1. Service Format. Services may be provided through one or more of the following formats as agreed upon:

    1. In-person consultations at client's home

    2. Telehealth/virtual consultations (phone, video conferencing)

    3. Email support and written materials

    4. Text message check-ins (if applicable)

    5. Educational materials, plans, and resources

  2. Telehealth Services. If services are provided via telehealth (video, phone, or other electronic means), I understand:

    1. Technology requirements and reliable internet/phone connection are my responsibility.

    2. Confidentiality cannot be guaranteed over electronic communications.

    3. Sessions may be interrupted by technical difficulties.

    4. I am responsible for being in a private, safe, and appropriate location during sessions.

    5. Provider is physically located in Colorado and services are delivered in accordance with Colorado law.

  3. Communication Boundaries. Provider maintains professional boundaries and typical business hours. While Provider may offer limited email or text support as part of service packages, Provider is not available 24/7 and response times may vary. Emergency situations require immediate medical attention (call 911) and cannot be addressed through Provider's services.

  4. Response Time. Provider will make reasonable efforts to respond to non-urgent communications within 24-48 hours during business days. I understand that delays may occur and that I should seek medical care if I have urgent concerns about my child's health.

6. Fees, Payment, and Cancellation Policy

  1. Service Fees. I agree to pay the fees for services as outlined in the selected service package or as otherwise agreed in writing.

  2. Payment Terms. Payment for services is due as follows:

    1. Single Sessions: Payment is due in full at the time of booking, prior to the scheduled session.

    2. Packages and Programs: Payment is due in full at the time of booking.

  3. Cancellation and Rescheduling. To cancel or reschedule a session, I must provide at least 24 hours advance notice prior to the scheduled session start time by contacting Provider at 734-2703 or SteamboatLactationSleep@gmail.com. Cancellations or rescheduling requests made with less than 24 hours notice will result in forfeiture of the session. First-time clients may receive one courtesy waiver of the late cancellation fee at Provider's discretion.

  4. Refund Policy.

    1. Single Sessions: Single session fees are non-refundable once booked.

    2. Packages and Programs: Package fees are non-refundable after 3 days from purchase or after the first session is completed, whichever occurs first.

7. Confidentiality and Privacy

  1. Privacy Practices. Provider respects your privacy and maintains confidential records in accordance with professional standards and applicable law. Information you provide will be kept confidential except as required or permitted by law.

  2. Limits to Confidentiality. Provider may be required to disclose confidential information without my consent in the following circumstances:

    1. Mandatory Reporting: Provider is required by Colorado law to report suspected child abuse, neglect, or endangerment to appropriate authorities.

    2. Imminent Harm: If Provider believes there is an imminent risk of serious harm to a child or another person.

    3. Legal Requirements: If disclosure is required by court order, subpoena, or other legal process.

    4. Medical Emergencies: If disclosure is necessary to address a medical emergency.

  3. Mandatory Reporting Obligations. As a provider working with children and families in Colorado, Provider is a mandatory reporter under Colorado law. If Provider reasonably suspects child abuse or neglect, Provider is legally obligated to report such suspicions to county child protective services or law enforcement. Provider will inform me of such reports unless doing so would jeopardize the child's safety.

  4. Use of Information. Provider may use de-identified, aggregated information for business purposes, quality improvement, or educational purposes. Provider will not share identifiable personal information for marketing purposes without written consent.

8. Records and Documentation

  1. Client Records. Provider maintains records of services, which may include intake forms, session notes, correspondence, and service plans, in accordance with professional standards.

  2. Access to Records. I may request access to my records by submitting a written request to Provider. Provider will respond in accordance with applicable law and professional standards.

  3. Record Retention. Provider retains client records for a minimum of seven (7) years after the date of the last client encounter. Records pertaining to minor clients are retained until the client reaches age 25, or for seven (7) years after the last encounter, whichever is longer, in accordance with Colorado professional standards and applicable laws. De-identified or aggregated information may be retained indefinitely for research and quality improvement purposes. After the applicable retention period, records will be securely destroyed in a manner that protects client confidentiality.

9. Informed Consent and Assumption of Risk

  1. Voluntary Participation. My participation in Provider's services is completely voluntary. I may discontinue services at any time.

  2. Risks and Benefits. I understand that while lactation support and sleep coaching services may provide education, guidance, and support that can benefit my family, there are potential risks, including:

    1. Services may not achieve desired outcomes.

    2. Implementation of strategies may initially cause temporary disruption or distress.

    3. Individual results vary and cannot be guaranteed.

    4. Lack of medical oversight if I do not maintain regular pediatric care.

  3. Responsibility for Implementation. I am solely responsible for deciding whether and how to implement any information, guidance, or strategies provided by Provider. I agree to use my own judgment, consult my child's healthcare providers as appropriate, and prioritize my child's safety and well-being at all times.

  4. Assumption of Risk. I knowingly and voluntarily assume all risks associated with participating in Provider's services and implementing any recommendations, guidance, or strategies.

10. Release and Limitation of Liability

  1. Release of Liability. To the fullest extent permitted by law, I release, discharge, and hold harmless Provider, Steamboat Lactation & Sleep, and their respective owners, employees, contractors, and agents from any and all claims, demands, liabilities, damages, or expenses (including attorneys' fees) arising out of or related to my participation in services, my implementation or non-implementation of information or strategies provided, or any acts or omissions by Provider except those constituting gross negligence or willful misconduct.

  2. Limitation of Liability. Provider's total liability for any claim arising out of services provided shall not exceed the total amount paid by me for services during the six (6) months preceding the claim.

  3. Indemnification. I agree to indemnify and hold harmless Provider from any claims brought by third parties arising out of my participation in services or my actions in implementing or relying upon information provided.

11. Independent Contractor Relationship

I understand that Provider is an independent contractor and is not an agent or employee of any hospital, medical practice, or other healthcare organization. Provider is solely responsible for the services provided.

12. Consent to Services

I hereby voluntarily consent to receive lactation support and/or sleep coaching services from Steamboat Lactation & Sleep. I acknowledge that I have had the opportunity to ask questions, and all of my questions have been answered to my satisfaction.

13. Governing Law and Dispute Resolution

  1. Governing Law. This agreement and all services provided shall be governed by and construed in accordance with the laws of the State of Colorado, without regard to conflicts of law principles.

  2. Venue. Any legal action or proceeding arising out of or relating to this agreement or the services provided shall be brought exclusively in the state or federal courts located in Routt County, Colorado, and I consent to the jurisdiction and venue of such courts.

  3. Severability. If any provision of this agreement is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

14. Entire Agreement and Modifications

This Consent for Services, together with any written service agreements or packages, constitutes the entire agreement between me and Provider regarding the services. This agreement may only be modified in writing signed by both parties.

15. Amendments and Updates

Provider may update this Consent for Services periodically to reflect changes in laws, regulations, professional standards, business practices, or services offered. The current version will be available at www.SteamboatLactationSleep.com/consent-for-services. Clients will be provided with the current version prior to beginning services. Material changes will be communicated to active clients when applicable. Continued services after notification of material changes may require acknowledgment of the updated agreement.