KAIROS HABIT LAB

Discovery Form
& Medical Forms

THE RIGHT HABITS AT THE RIGHT TIME

Important — please read before proceeding. The Discovery Form is reviewed exclusively by your Lifestyle Coach. The Medical History Disclosure Form is reviewed exclusively by the licensed Medical Team. Your coach does not have access to any medical information you disclose. These forms are legally separate documents with separate ownership.

Coach access only

Lifestyle Discovery Form

Your complete lifestyle assessment — sleep, food, activity, stress, goals, and informed consent. Reviewed only by your Lifestyle Coach.

9 sections
2 signatures required
11-clause informed consent included
No medical data collected
Open form →
Medical team only

Medical History Disclosure

Confidential clinical disclosure reviewed exclusively by the licensed Medical Team. Your Lifestyle Coach has no access to this form or its contents.

8 clinical sections
Client First Medical Team
Handoff certificate
Confidential — not shared with coach
Open form →
How this works — step by step
1
Client completes the Discovery Form Lifestyle assessment + informed consent. Submitted directly to your Lifestyle Coach. No clinical data involved.
2
Coach reviews and confirms fit Coach assesses lifestyle data and determines program suitability before any medical referral is made.
3
Client completes the Medical History Disclosure Form Submitted directly and exclusively to the Medical Team. The Coach does not open, review, or access this form at any point.
4
Medical Team reviews and signs the Handoff Certificate MT confirms clinical suitability. The signed Handoff Certificate — not the medical form — is placed in the coaching client file.
5
Program begins on Day 1 Both forms completed. Handoff Certificate on file. You may now proceed with the full protocol.