TOX: Total Toxic Load Assessment INFORMED CONSENT & WAIVER

Client Agreement, Informed Consent, and Release

Conscious Kitchen ATX, LLC  |  Austin, Texas

Please read this Agreement carefully before you book or participate in a TOX Total Toxic Load Assessment

By signing below, you confirm that you have read, understood, and agreed to every provision in this Agreement.

1. Parties and Purpose

This Client Agreement, Informed Consent, and Release (the “Agreement”) is entered into between you (the “Client,” “you,” or “your”) and Conscious Kitchen ATX, LLC, a Texas limited liability company, together with Dr. Nikki Siso (collectively, “Conscious Kitchen ATX,” “we,” “our,” or “us”). This Agreement governs your purchase of, and participation in, the TOX Total Toxic Load Assessment (the “TOX” evaluation).


2. About Your Practitioner

Dr. Nikki Siso holds a Doctor of Philosophy (PhD) in Holistic Health and Nutrition and a Master of Science in Sustainability. She is a Certified Holistic Health Practitioner. The title “Dr.” used by Dr. Nikki Siso refers to her academic doctorate.

Dr. Nikki Siso is not a medical doctor (M.D.), is not licensed by the Texas Medical Board, and does not practice medicine, nursing, psychology, dietetics, mental health counseling, or any other state-licensed healing art. Dr. Nikki Siso does not diagnose, treat, cure, prevent, or mitigate any disease, illness, injury, or other physical, mental, or emotional condition. The services described in this Agreement are educational and informational only.


3. Nature of the TOX Total Toxic Load Assessment

The TOX Evaluation is a forty-five-minute educational and informational consultation. During the TOX Evaluation, Dr. Nikki Siso reviews self-reported information you provide about (a) environmental exposures in your home, (b) your dietary patterns and food choices, and (c) your emotional, behavioral, and lifestyle patterns. After the call, you receive a written report (the “TOX Report”) that organizes the information you shared, identifies possible educational correlations between your reported exposures and your reported symptoms, and offers general educational suggestions about lifestyle, dietary, environmental, and self-care modifications you may wish to discuss with your licensed healthcare provider.

The TOX Evaluation and the TOX Report are provided solely for educational and informational purposes. They are not a medical evaluation, not a clinical diagnosis, not a prescription, not a treatment plan, not laboratory analysis, and not a substitute for advice, diagnosis, or treatment from a licensed healthcare provider.

4. The TOX Evaluation Is Not Medical Care

You acknowledge and agree that:

  • Conscious Kitchen ATX does not provide medical care of any kind.

  • The TOX Evaluation is not a substitute for evaluation, diagnosis, or treatment by a licensed physician, advanced practice provider, registered dietitian, licensed psychologist, licensed counselor, or other licensed healthcare professional.

  • Conscious Kitchen ATX makes no claim, express or implied, that the TOX Evaluation, the TOX Report, or any related communication will diagnose, treat, cure, prevent, or mitigate any disease, illness, or condition.

  • You will not use the TOX Evaluation, the TOX Report, or any related communication as a basis for delaying, declining, terminating, or altering any care prescribed or recommended by your licensed healthcare provider.

  • Any decision you make about your health, including any decision to start, stop, or change a medication, supplement, food, behavior, or therapy, is your decision alone, and should be made with the input of a qualified licensed healthcare professional.

5. Your Responsibility to Maintain Medical Care

You agree to maintain a relationship with one or more licensed healthcare providers for the diagnosis and treatment of any medical condition. You agree to consult with that provider before making any change to your medical care, prescribed medications, or treatment plan, and before beginning any new diet, supplement protocol, exercise program, fasting protocol, herbal protocol, juice cleanse, or detoxification practice.

You agree to seek immediate medical attention from a licensed physician or emergency provider if you experience any acute, severe, or worsening symptom, including without limitation chest pain, shortness of breath, severe abdominal pain, fainting, seizure, severe headache, suicidal thoughts, or any sign of a medical emergency. The TOX Evaluation is not appropriate for emergency conditions, and Conscious Kitchen ATX is not equipped to respond to medical emergencies.

6. Health Disclosure and Contraindications

You represent that you have disclosed to Conscious Kitchen ATX, in your intake materials and during the TOX Evaluation, all material aspects of your health history that may affect your participation, including without limitation: pregnancy or possible pregnancy, current breastfeeding, eating disorders or history of disordered eating, diabetes (Type 1 or Type 2), kidney disease, liver disease, gallbladder disease, cardiovascular disease, autoimmune disease, cancer history, mental health diagnoses, current medications, and current supplements. You agree to update Conscious Kitchen ATX promptly if any of these change. You acknowledge that incomplete or inaccurate health information may affect the educational suggestions in your report and that Conscious Kitchen ATX has relied on the truthfulness and completeness of your disclosures.

7. Voluntary Participation and Assumption of Risk

Your participation in the TOX Evaluation is voluntary. You acknowledge that participation, including any subsequent decision to alter your home environment, diet, supplement use, or lifestyle based on the educational suggestions in the TOX Report, carries inherent risks. These risks include, without limitation, allergic or sensitivity reactions to recommended foods or environmental products, gastrointestinal upset, fatigue, emotional discomfort, the surfacing of difficult feelings or memories, and the possibility that lifestyle changes may not produce the outcomes you hope for, or may produce unintended outcomes. You voluntarily and knowingly assume full responsibility for these and any other risks associated with the TOX Evaluation and any choices you make as a result of it.

8. No Guarantee of Results

Health and wellness outcomes vary widely by individual. Conscious Kitchen ATX makes no guarantee, representation, or warranty that you will experience any particular outcome, symptom relief, or result from participating in the TOX Evaluation, reading your TOX Report, or following any educational suggestion. Any testimonials, case studies, or examples shared by Conscious Kitchen ATX are illustrative only and are not guarantees of your individual results.

9. Confidentiality and Privacy

Conscious Kitchen ATX treats the information you share as confidential. Conscious Kitchen ATX is not a “covered entity” under the federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), and the protections of HIPAA do not apply to information you share with us. We will not sell your personal information. We may share your information with our professional team members, contractors, and service providers (such as scheduling, payment processing, and email vendors) who need access in order to provide services to you, and we will require those parties to maintain confidentiality consistent with this Agreement. We may also share information when required by law, when necessary to respond to a credible threat of harm, or with your written consent.

10. Recordings, Photographs, and Communications

TOX Evaluation calls may be audio recorded for quality, accuracy, and report-generation purposes. You consent to the recording of your call. Recordings are retained as part of your client file. We will not use any recording, photograph, image, or quotation that identifies you for marketing purposes without your separate written consent.

You consent to receive Agreement-related and program-related communications from us by email, telephone, and SMS at the contact information you provide. Standard message and data rates may apply. You may opt out of marketing messages at any time.

11. Fees, Cancellation, and Refunds

The fee for the TOX Total Toxic Load Assessment is the amount displayed at checkout at the time of purchase. Payment is due in full at the time of booking, unless a written payment plan is expressly agreed to by Conscious Kitchen ATX.

If you cancel or reschedule your TOX Evaluation more than seventy-two (72) hours before your scheduled call, we will reschedule one time at no additional charge. If you cancel or reschedule less than seventy-two (72) hours before your scheduled call, or do not appear (no-show), the fee is forfeited and the appointment must be rebooked at full price.

Because the TOX Evaluation is a custom, time-intensive professional service that begins with intake review and pre-call preparation, all fees are non-refundable once your intake form is submitted, except as required by law or as expressly agreed by Conscious Kitchen ATX in writing.

12. Release and Waiver of Liability

To the fullest extent permitted by Texas law, you, on behalf of yourself, your spouse, your heirs, your assigns, and your personal representatives, release, waive, discharge, and covenant not to sue Conscious Kitchen ATX, LLC, Dr. Nikki Siso, Dr. Sara Siso, and their respective members, managers, employees, contractors, agents, and affiliates (collectively, the “Released Parties”) from any and all claims, liabilities, demands, damages, losses, costs, or expenses, of any kind, whether known or unknown, arising out of or related to your participation in the TOX Evaluation or your use of any information provided by Conscious Kitchen ATX, except where such claims arise from the gross negligence or willful misconduct of a Released Party.

13. Indemnification

You agree to defend, indemnify, and hold harmless the Released Parties from and against any third-party claim, demand, loss, or expense (including reasonable attorneys’ fees and court costs) arising out of or related to (a) your breach of this Agreement, (b) your acts or omissions, including any decision you make about your health, or (c) your violation of any law or the rights of any third party.

14. Limitation of Liability

To the fullest extent permitted by Texas law, the total cumulative liability of the Released Parties to you for any and all claims arising out of or related to this Agreement or the TOX Evaluation shall not exceed the total amount of fees you actually paid to Conscious Kitchen ATX for the TOX Evaluation. The Released Parties shall not be liable for any indirect, incidental, consequential, special, exemplary, or punitive damages, including without limitation lost profits, lost income, lost business opportunities, or emotional distress, even if advised of the possibility of such damages.

15. Dispute Resolution and Arbitration

The parties shall first attempt to resolve any dispute, claim, or controversy arising out of or relating to this Agreement or the TOX Evaluation through good-faith informal negotiation. If the matter is not resolved within thirty (30) days, the parties shall participate in non-binding mediation in Travis County, Texas, with a mediator mutually agreed upon by the parties.

If the matter is not resolved through mediation, the dispute shall be finally resolved by binding arbitration administered by the American Arbitration Association under its Commercial Arbitration Rules, by a single arbitrator, in Travis County, Texas. Judgment on the arbitration award may be entered in any court having jurisdiction. The parties waive any right to a jury trial and any right to participate in a class action or class arbitration. This arbitration provision is governed by the Federal Arbitration Act and, to the extent it applies, the Texas General Arbitration Act (TX Civ. Prac. & Rem. Code Ch. 171). This Section does not prevent either party from seeking injunctive relief in court to protect intellectual property or confidential information, or from filing a complaint with a governmental agency.

16. Governing Law and Venue

This Agreement is governed by and construed in accordance with the laws of the State of Texas, without regard to its conflict of laws principles. The parties agree that the exclusive venue for any action permitted to be brought in court (including to compel arbitration or to enforce an arbitration award) shall be in the state or federal courts located in Travis County, Texas.

17. Electronic Signature and Delivery

You consent to the use of electronic records and electronic signatures in connection with this Agreement, consistent with the federal Electronic Signatures in Global and National Commerce Act (E-SIGN) and the Texas Uniform Electronic Transactions Act (TX Bus. & Com. Code Ch. 322). An electronic signature, whether typed, drawn, or selected from a checkbox confirmation, has the same legal force and effect as a handwritten signature. You are entitled to receive a copy of this Agreement upon request.

18. Severability, Assignment, and Entire Agreement

If any provision of this Agreement is found by an arbitrator or court of competent jurisdiction to be unenforceable, the remaining provisions remain in full force and effect, and the unenforceable provision shall be modified to the minimum extent necessary to be enforceable. You may not assign this Agreement without our prior written consent. We may assign this Agreement in connection with a sale, merger, or reorganization. This Agreement, together with any policies referenced at checkout, constitutes the entire agreement between the parties regarding the TOX Evaluation, and supersedes any prior or contemporaneous communications.

19. Acknowledgment

By signing below, you acknowledge that you have read this Agreement in full, have had the opportunity to ask questions, understand that the TOX Total Toxic Load Assessment is an educational and informational service and is not medical care, and agree to be bound by every term of this Agreement, including the release of liability, arbitration provision, and class action waiver.

FIND US

West Lake Hills,

Austin, Texas

ADDRESS
3620 Bee Caves Road, Suite C
West Lake Hills, TX 78746

HOURS

Mon – Sat: 10am – 6pm

Sunday: Closed

PRIVATE BOOKINGS

3620 Bee Caves Road, Suite C
West Lake Hills, TX

Conscious Kitchen ATX

We read the labels so you need to. A 100% dedicated organic, gluten-free, whole food plant-based kitchen in West Lake Hills.

MEDICAL DISCLAIMER Dr. Nikki Siso and Dr. Sara Siso are Certified Holistic Health Practitioners, not medical doctors. Information provided by Conscious Kitchen ATX, Conscious Kitchen Method, and all associated programs is for educational purposes only. Not intended as medical advice. Always consult your physician before making health changes.

Full Disclaimer | Privacy Policy | Terms of Service

© 2026 Conscious Kitchen ATX. All Rights Reserved.

FIND US

West Lake Hills,
Austin, Texas

ADDRESS

3620 Bee Caves Road, Suite C
West Lake Hills, TX 78746

HOURS

Mon – Sat: 10am – 6pm

Sunday: Closed

3620 Bee Caves Road, Suite C
West Lake Hills, TX

Conscious Kitchen ATX

We read the labels so you don't need to. 100% dedicated organic, gluten-free, whole food plant-based kitchen in West Lake Hills.

MEDICAL DISCLAIMER Dr. Nikki Siso and Dr. Sara Siso are Certified Holistic Health Practitioners, not medical doctors. Information provided by Conscious Kitchen ATX, Conscious Kitchen Method, and all associated programs is for educational purposes only. Not intended as medical advice. Always consult your physician before making health changes. Full Disclaimer | Privacy Policy | Terms of Service

© 2026 Conscious Kitchen ATX. All Rights Reserved.