This Acknowledgment contains important information, including information about certain health risks associated with losing weight generally and restrictions regarding participation in the following HMR weight management plans (the “HMR Program Plans”) offered by HMR Weight Management Services Corp. (“HMR”). The HMR Program Plans, as referred to in this Acknowledgment, are Healthy Solutions® at Home with or without group phone or video conferencing support and HMR Healthy Shakes® (and collectively referred to as “Remote Programs”). Both Remote Programs include Phase 1 and Phase 2 (described in more detail below) and require purchase of “auto delivery” of HMR meal replacement products (“HMR Products”) as a condition for participation. Other purchase options for HMR Products, “a la carte” and “guest” purchases are not considered Remote Programs as used in this Acknowledgment. The general information provided in this material is provided for the benefit of all persons who are considering managing their weight through diet and physical activity even if not participating in one of the Remote Programs or purchasing HMR Products.

YOU SHOULD CONSULT WITH YOUR HEALTHCARE PROVIDER PRIOR TO STARTING ANY WEIGHT-LOSS PROGRAM OR OTHER DIET REGIMEN. Any weight-loss program can pose health risks if not evaluated with your current medical condition(s) and should be assessed by a medical professional to determine if it is right for you. As a participant, you accept the responsibility to seek initial and ongoing medical advice from your healthcare provider or qualified healthcare professional.

Although the Remote Programs have been demonstrated to be effective, they are not right for everyone. If you have certain medical conditions, you should not participate in either of the Remote Programs. Even if you do not participate in one of the Remote Programs you should still consult with your healthcare provider before starting any diet or similar weight-loss regimen, including the purchase of HMR Products to support weight loss on your own “plan.” 

I understand that, in addition to any guidance I may receive from my healthcare provider, The Remote Programs (Healthy Solutions at Home and Healthy Shakes) are not appropriate for, and must not be used by, individuals with the following conditions:

• Pregnancy. Women who become pregnant or suspect that they are pregnant must immediately contact HMR at the number below and understand that they will not be allowed to continue in any of the Remote Programs.
• Women who have been breastfeeding for less than 12 weeks and would like to continue breastfeeding.
• Active eating disorders (anorexia, bulimia).
• Allergic to milk protein, egg or corn. (Note: Lactose sensitivity or intolerance can be managed by using the HMR 70 Plus lactose-free shakes.)
• Have had bariatric surgery within the last year.
• Under 18 years of age.
• Currently receiving any of the following treatments for obesity: nerve stimulation therapy (e.g., VBLOC®), aspiration pump therapy (e.g., AspireAssist™), or placement of an intragastric stomach balloon (e.g., ORBERA™).
• Actively abusing alcohol, prescription, or non-prescription drugs. 
• End stage liver disease
• End stage kidney disease.
• Advanced stage D heart failure.

If you have any of the above conditions, you cannot participate in either Phase 1 or Phase 2 of the Remote Programs. If you know or suspect that you have any of these conditions after you enroll in one of the Remote Programs through this Website, you should immediately notify HMR by calling 1-800-418-1367 and then discontinue your participation in Phase 1 or Phase 2 of the applicable HMR Program Plan. In that event, you will be eligible to return any unopened HMR Products you have purchased for refund. Complete details can be found by reviewing the Shipping and Return Policy.

In addition, the Remote Programs (Healthy Solutions at Home and Healthy Shakes) should be used by individuals with the following conditions only if they work with their healthcare provider and he or she agrees to provide close medical management as specified below:

• Taking anti-seizure or antipsychotic medications for treatment of any condition.
• Taking Coumadin® (warfarin). See additional information below in the section titled Important Information for People Who Are Taking the Anticoagulant (Blood Thinner) Coumadin.
• Taking insulin products. Insulin needs will change very quickly. You will need to do frequent self-glucose monitoring and obtain provider agreement to provide frequent clinical contact (see the additional information about insulin use below in the section IMPORTANT INFORMATION FOR PARTICIPANTS WITH DIABETES WHO TAKE INSULIN.)
• Have had a heart attack or stroke, including TIAs (transient ischemic attacks), in the last 12 weeks.
• Taking medication for high blood pressure, including diuretics (water pills). See additional information below in the section titled Important Information for People Who Are Taking Diuretics (Water Pills) and Other Drugs for High Blood Pressure.

If you have any of the above conditions, you must agree to take responsibility to consult with your healthcare provider before beginning the program and to follow your healthcare provider’s instructions for ongoing medical management.

Benefits and Potential Health Risks

The Remote Programs are designed to provide you with information on weight loss, physical activity, and healthy lifestyle behaviors. HMR Program staff and materials provide instruction and coaching that can help you reach a healthier weight and lifestyle, including information provided in the Remote Program Kit you will receive when you join Phase 1 of either of the Remote Programs. None of the Remote Programs offered on this Website are very low-calorie diets. Remote Programs offered on this Website do not provide medical screening, medical monitoring, or ongoing medical care and advice. Although some health coaches and program specialists may be medical professionals or dietitians, such persons will not be practicing or otherwise functioning in such capacities when acting as a HMR Program health coach or providing customer service support.

The Remote Programs include two phases. Phase 1 of the Remote Programs utilizes a structured diet using HMR meal replacement foods (HMR Products) and other foods you select, along with regular physical activity, to focus on achieving weight loss. Phase 2 of the Remote Programs focuses on practicing healthy lifestyle skills that can support successful long-term weight management.

Although reduction of caloric intake, increased physical activity, and coaching is likely to result in weight loss, HMR cannot guarantee that weight loss or maintenance of weight loss will occur by participation in any of the Remote Programs. Medical studies indicate that people who are overweight or obese (with a BMI of 25 or greater) are at increased risk of many health problems and diseases including heart disease, diabetes, gallbladder disease, kidney disease, gout, osteoarthritis, neurological disorders, and certain types of cancer. Although no guarantees are made with regard to the results of any Program, the likelihood that health risks associated with being overweight will be reduced is statistically better with the achievement of an ideal body weight.

At the same time, it is important to know that certain health risks have been associated with losing weight in general. Any weight-loss program may be associated with side effects including, but not limited to, the following: dizziness or light headedness, bowel changes, muscle cramps, fatigue, temporary anemia, cold sensation, menstrual irregularities, dry skin, temporary skin rash, and temporary hair loss. The following may also be associated with weight loss: the aggravation of pre-existing gallbladder disease, the development of gallbladder sludge or crystals, the appearance of previously undetected gallstones, or the development of gallstones. The development of gallbladder disease could result in the need for surgical removal of the gallbladder. These conditions can also cause inflammation of the pancreas. Pancreatitis can be a serious condition and can become a chronic problem, lasting after any gallbladder disease has been resolved. A small percentage of people may develop symptoms related to gallbladder disease during any weight-reducing diet, including this diet using meal replacement products. A small percentage of people after a considerable weight loss (usually 50 or more pounds) may develop temporary neurological symptoms such as limb weakness or numbness. Avoiding activities that cause compression on nerves, such as prolonged crossing of legs, may help prevent this.

Weight-loss Phase (Phase 1) for Remote Programs:

The Remote Program’s Phase 1 diet, increases in physical activity, and associated weight loss may result in changes in medical conditions and/or the need to adjust medications. Your healthcare provider may recommend medical monitoring while on Phase 1 of your diet for a number of medical conditions including, but not limited to, diabetes, high blood pressure, cardiac disease, and kidney disease.

It is important that you speak with your healthcare provider about any medical conditions that you may have or any medications that you are taking that could be affected by diet, increases in physical activity, or weight loss. In particular, please review the following important information as you will be asked to acknowledge that you have read and understand this information as a part of your check-out process:

Important Information for People Who Are Taking Medication(s) to Treat Diabetes

• If I am taking diabetes medications, I understand and acknowledge that it is important for me to contact my healthcare provider prior to starting either of the Remote Programs offered on this Website to arrange for medical monitoring during my participation in the selected Remote Program.
• I understand and acknowledge that the use of insulin and/or oral agents, in combination with dietary changes, increased physical activity, and/or weight loss, can increase the risk of low blood sugars (hypoglycemia) and may require my healthcare provider to reduce and/or eliminate the dose(s) of my medication(s) in order to reduce the risk of low blood sugars.
• I understand and acknowledge that I need to carefully monitor my blood sugars and review my self-monitored blood glucose (SMBG) log with my healthcare provider before starting any of the Remote Programs offered on this site and continue to do so during the diet to prevent low blood sugar (hypoglycemia) and poor glycemic control while facilitating weight loss.

 

IMPORTANT INFORMATION FOR PARTICIPANTS WITH DIABETES WHO TAKE INSULIN If you are taking insulin for treatment of diabetes, you will need close medical supervision by your healthcare provider in advance of and during your participation in the Remote Programs offered on this Website because changes in your level of physical activity, changes in your diet, and/or weight loss may result in the need for a reduction in your insulin dose. The potential need for decreases in insulin doses is most common during the initial weeks of participation. In some individuals, insulin may need to be discontinued.  Changes in physical activity, dietary changes, and/or weight loss may put you at risk for low blood sugar (hypoglycemia) especially if you are on insulin. Hypoglycemia, if not treated, can cause seizures and may be life-threatening. As with any medication, any dose changes or discontinuation of medication is a decision that should be made by, and discussed with your HCP. Some signs and symptoms of low blood sugar may include: dizziness or lightheadedness, sweating, confusion, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, mood changes, or hunger. Low blood sugar can impair concentration and reaction time; this may place an individual and others at risk in situations where these abilities are important (e.g., driving, or operating other machinery). Your healthcare provider can advise you of what to do in the event that you experience low blood sugar. In order to minimize your risk of low blood sugar, you will need close medical supervision from your healthcare provider so that they may make appropriate changes in your insulin dose, especially during the first few weeks of the HMR Program. Ask your healthcare provider what your blood sugar range should be and when and how frequently you should check your blood sugar levels.

Important Information for People Who Are Taking Diuretics (Water Pills) and Other Drugs for High Blood Pressure – you need to know the following:

• If I am taking high blood pressure medications, including diuretics (water pills), I understand and acknowledge that I should contact my healthcare provider prior to beginning any of the Remote Programs to arrange for medical monitoring during Phase 1 of the selected Remote Program.
• I understand and acknowledge that being on high blood pressure medication or diuretics, while on a low-salt, weight-reducing diet, such as one of the Remote Program diets, may cause me to experience dizziness, fatigue, and low blood pressure. Accordingly, my HCP may need to adjust or discontinue these medications to prevent possible side effects. It is very important to have continued contact with my HCP to evaluate my blood pressure and medications. I agree to contact my HCP if I experience any symptom of low blood pressure, such as excessive fatigue or dizziness, especially upon changing positions quickly. 

Important Information for People Who Are Taking the Anticoagulant (Blood Thinner) Coumadin® (warfarin) – you need to know the following:

• I understand and acknowledge that the HMR Shakes, Chicken Soup, and Multigrain Hot Cereal are fortified with vitamin K, which counteracts the effect of Coumadin on thinning your blood. The vitamin K content of HMR products is labeled on each package/container. I should take the same number of vitamin K fortified products daily to maintain an even level of vitamin K in my blood. This will assist my HCP in managing my medication. I will need regular blood tests by my HCP to evaluate the effectiveness of my medication. I agree to contact my HCP when I start the diet to discuss ongoing monitoring of my PT/INR levels and have them make any necessary medication adjustments. (This information is located on the Diet Information to Share with Your Primary Care Provider sheet in your HMR Program materials.) If I am taking the blood thinner Coumadin (warfarin) this may result in a need to have this medication adjusted.

Important Information for People Who Are Taking Anti-Seizure and Antipsychotic Medications or Other Medications that Reduce Serum Sodium Levels-- you need to know the following:

• The Healthy Solutions diet is a lower sodium eating plan than the traditional American diet. Therefore, additional monitoring by my HCP is advisable during participation in the weight-loss process to ensure appropriate medication adjustment in order to minimize the risk of hyponatremia (low sodium). 

Important Information for People Who Have Had a Heart Attack or Stroke, Including TIA's (Transient Ischemic Attack) in the Last 12 Weeks-- you need to know the following:

• It is important for me to consult my HCP regarding medication adjustments and any physical activity limitations and to follow his or her recommendations. I will contact my HCP if I experience dizziness, fatigue, or low blood pressure especially opon changing positions quickly. 

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I understand that the possibility always exists that the combination of any significant disease, such as obesity, with methods employed for its treatment, such as the Remote Programs, may lead to previously unobserved or unexpected ill effects, as described in the Benefits and Potential Health Risks section above. Please consult with your healthcare provider if you have any concerns regarding these risks. We have provided a Diet Information to Share with Your Primary Care Provider sheet in your Remote Program materials, which you will receive in your first order. This is a material for you to provide to your healthcare provider or primary care provider.

Maintenance Phase (Phase 2):
Following the weight-loss phase (Phase 1) of the Remote Programs, there is a weight-maintenance phase of the Program (Phase 2). You may decide to enter Phase 2 of the selected Remote Program after participating in Phase 1 of your selected Program or after first attending the HMR Program for Weight Management™ in person in a clinic setting. The primary goal of Phase 2 of both Remote Programs is to learn how to better manage your weight by:

1. incorporating higher levels of physical activity (PA) into your daily routine;
2. managing overall calorie intake through the use of HMR meal replacements (HMR Products), eating vegetables and fruits, and making healthy food choices.

Phase 2 of the Remote Programs has the same exclusions for participation and other restrictions as the weight-loss phase (Phase 1), which have been set forth in the previous sections of this Acknowledgment with the exception of allergies to milk protein, corn, and egg since the HMR meal replacements in Phase 2 do not include a prescribed plan that requires use of HMR Shakes. Current medications and medical conditions may be affected as a result of practicing the lifestyle changes promoted in Phase 2 (weight maintenance) of the Remote Programs and any additional weight loss achieved while in Phase 2 may require ongoing adjustments to certain medications for, but not limited to:

1. diabetes management
2. anti-coagulation therapy (Coumadin)
3. blood pressure

When you transition to Phase 2, you are continuing in your selected Remote Program and the acknowledgment and consent you provide to the information, conditions, and exclusions in this Acknowledgment will continue to apply for the duration of your participation in your selected Remote Program. In particular, when beginning Phase 2 it is advisable to:

• contact your healthcare provider and inform them of the new diet phase you are entering, and discuss any relevant changes to the management of  any  medications or medical conditions that may be affected by participation in Phase 2 of your Remote Program.
• consult with your healthcare provider about managing or monitoring any current or new medical conditions that may appear during your participation in the Phase 2 of your Remote Program.

CONSENT TO PARTICIPATION IN REMOTE PROGRAM

If you select the Healthy Solutions at Home Program with group phone or video conferencing coaching classes also referred to as the “Remote Program” in the Privacy Policy you are directed to the section in the Privacy Policy called IMPORTANT DISCLOSURE REGARDING THE HMR HEALTHY SOLUTIONS PROGRAM WITH REMOTE COACHING ("REMOTE PROGRAM"). That section will detail the additional uses and disclosures by HMR and others of your personal information if you participate in that Remote Program option. Please review carefully – your participation in the Remote Program and acceptance of this Acknowledgment at checkout for your purchase of HMR Products constitutes a consent to the uses and disclosures of your personal information set forth in that section in addition to the other uses and disclosures described in the Privacy Policy. In addition, if you are participating in the Remote Program through a Sponsor (your employer or healthcare provider) and using a Sponsor code or were given a special web link (URL) to use when setting up your Account (My Account) on this Website, your employer, insurer, or healthcare provider ("Sponsor") may receive certain personal information about your participation in the Remote Program described in the next section entitled SPECIAL SPONSOR NOTICE SECTION.

SPECIAL SPONSOR NOTICE SECTION

You have indicated that you are participating in the HMR Program Plan as a part of a health or wellness initiative offered through your Sponsor. If you believe this is not correct you should notify HMR immediately by calling 1-800-418-1367. For those who are participating as a part of a health or wellness initiative, please review the special information below about how information about you and your participation will be provided to your Sponsor.

As part of making these special program arrangements for participants like me, I acknowledge that, in addition to the other data described in this Privacy Policy on this website, HMR will provide my Sponsor and/or its affiliate with personally identifiable information about me in the form of a "Participation Verification Report," which will include my name, ID number, and whether I attended a minimum number of weeks in the Remote Program as may be required by my Sponsor. I understand that by providing my ID number it will be matched against a list of ID numbers provided to HMR by my Sponsor. This matching process is used to confirm who is eligible to participate in the Sponsor's health and wellness initiative. This ID number matching process and the Participation Verification Report are required in order to determine if I may be eligible for incentives provided by my Sponsor. HMR has no role in the determination or provision of such incentives and will provide the Participation Verification Report solely for use by my Sponsor.

Additionally, HMR will provide personally identifiable information about me periodically in the form of a separate "Individual Participation Report," which will also include my name, ID number, date of birth, and total number of weeks attended in the Remote Program. My Sponsor uses this report to monitor and evaluate employee participation in its employee wellness programs and the programs' impact on employee health outcomes and healthcare utilization.

Finally and as explained in more detail in the section of the Privacy Policy entitled HOW DOES HMR USE THE PERSONAL INFORMATION COLLECTED THROUGH THE WEBSITE AND/OR THE HMR MOBILE APP? - Reports to Your Local Program or Sponsor, you will be "associated" with your Sponsor and HMR will notify your Sponsor that you are "associated" with them on this Website and provide information about your Website purchases.

ACKNOWLEDGMENT AND CONSENT TO TERMS OF PARTICIPATION

When you complete your purchase of your HMR Program kit or Phase 2 order with auto delivery of HMR Products, you will be required to acknowledge that you have understood the information in this Acknowledgment, including that none of the Remote Program health exclusions apply to you.  Your acknowledgment will also constitute your consent to the terms of participation in your selected Remote Program, including uses of personal information in the Phone Program  as described above if you participate in that program. Please review this material carefully before completing such purchase.

By completing your purchase you will also be providing the following release from liability.

By providing this acknowledgment, I will be voluntarily assuming all risks and hazards associated with, or which may arise from my participation in the Remote Program I have selected, and, on my own behalf and on behalf of my heirs, personal representatives, and other beneficiaries, I hereby release HMR, its affiliates and their respective officers, directors, agents, and employees from any liability and claims of any kind arising from my participation in the selected Remote Program.