Client Consent Form Prysm iO Antioxidant Scan · Emma Crawford Nutrition Your details Full name * Date * Email * Phone Anything I should know? (e.g. health conditions, medication, pregnancy, skin conditions on your hands) About the scan The Prysm iO is a quick, painless scan of your fingertip using light. It estimates the level of carotenoids (antioxidants from colourful fruit and vegetables) in your skin. It is a wellness indicator only. It is not a medical test and cannot diagnose, treat or prevent any condition. Consent (please tick each box) I understand the scan is a non-invasive wellness indicator and not a medical test or diagnosis. For any health concerns I will speak to my GP. I agree to have the scan and for Emma Crawford Nutrition to record my score and the details on this form so that my nutrition advice can be personalised. I understand my scan is taken using the Prysm iO device and app (provided by Nu Skin), and my result may be stored within that app. Mailing list (optional) Yes, please add me to the mailing list for nutrition tips, recipes, news and offers from Emma Crawford Nutrition. I can unsubscribe at any time. Leave this box empty if you would rather not. Your information Your details are kept securely and used only to provide your service (and to send emails, if you opted in above). They are never sold or shared for marketing. You can ask to see, correct or delete your information, or withdraw consent, at any time by emailing emma@emmacrawfordnutrition.co.uk. Type your full name as your signature * Submit consent form
