Please Choose Your Preferred Investment Option

MRT/ LEAP Programs 2016 Please choose your preferred investment option: Gold Package: Intensive Nutrition Intervention: 12 appointments 3 Months

Option one: Invest in full up front for $3,240 and save $384 compared to payment option 2.

Option two: Secure my spot via monthly payment option of $1,208. Total investment is $3,624.

 MRT for 120 foods and 30 food chemicals  Express FedEx shipping of MRT blood draw to Oxford Biomedical Technologies  MRT results and getting started guide  Twelve consultations (30-60 min) to implement the various phases of your personal LEAP Diet  Tracking of symptoms and problem solving  Menu planning, food preparation ideas, recipes for meals and snacks for each phase (4 plans)  Grocery toolkit  Unlimited email for questions, troubleshooting, and tips during the 5 weeks of phases  Genova GI Effects stool testing, interpretation and plan

Dana Magee RD, LD, CLT offers her clients the patented MRT (Mediated Release Test) to determine food sensitivities and utilizes the LEAP (Lifestyle, Eating, and Performance) nutrition plan to remove food sensitivities from your diet. Food sensitivities contribute to symptoms of diarrhea, cramping, heartburn, headaches, migraines, fibromyalgia, muscle pain, joint pain, fatigue, and attention deficit disorder. Using these results we are able to feed the body an anti-inflammatory diet, heal the gut, and decrease or eliminate unwanted symptoms.

 Reduce reliance on medication  Look forward to trying new foods and dishes  Enjoy preparing meals for yourself and your family  Have confidence traveling, leaving the house and participating in social situations  Improve energy and mood

Please choose your preferred investment option: Platinum Package: Intensive Nutrition Intervention: 16 appointments 4 Months

 MRT for 120 foods and 30 food chemicals  Express FedEx shipping of MRT blood draw to Oxford Biomedical Technologies  MRT results and getting started guide  Sixteen consultations (30-60 min) to implement the various phases of your personal LEAP Diet  Tracking of symptoms and problem solving  Menu planning, food preparation ideas, recipes for meals and snacks for each phase (4 plans)  Grocery toolkit  Unlimited e-mail support for questions, troubleshooting, and tips during the 5 weeks of phases  SpectraCell Micronutrient Testing, interpretation of results along with a personal supplement plan  Genova GI Effects stool testing, interpretation and plan

Please choose your preferred investment option: Silver Package: 8 appointments 2 Months

 MRT for 120 foods and 30 food chemicals  Express FedEx shipping of MRT blood draw to Oxford Biomedical Technologies  MRT results and getting started guide  Eight consultations (30-60 min) to implement the various phases of your personal LEAP Diet  Tracking of symptoms and problem solving  Unlimited email for questions, troubleshooting, and tips  Menu planning, food preparation ideas, recipes for meals and snacks for each phase (4 plans)

Please choose your preferred investment option: Bronze Package: 8 appointments 2 Months

Option two: Secure my spot via $1,074 deposit, nonrefundable and remainder of the $716 balance at 3rd appointment. Total investment is $1,790.

 MRT for 120 foods and 30 food chemicals  Express FedEx shipping of MRT blood draw to Oxford Biomedical Technologies  MRT results and getting started guide  Five consultations (30-60 min) to implement the various phases of your personal LEAP Diet  Tracking of symptoms and problem solving  Phase 1 meal plan

Blood Draw Information

For your convenience we have a phlebotomist scheduled to do the MRT blood draw each month in our Greenbelt office at not cost to the client. These are typically held on a Wednesday morning, please contact us for dates. The phlebotomist can draw for the MRT and SpectraCell tests depending on what package the client chooses. While the MRT test does not have to be fasting. We will then send out your blood samples that day by FedEx Express for no additional cost. The Genova GI Effects test is a stool test that can be taken at home and send back via FedEx. If you are unable to make our scheduled blood draw dates you may pick up a MRT kit from our office or we can have the lab mail one to you directly. Please be advised that Quest and LapCorp will NOT do MRT, SpectraCell, or Genova blood work/testing. It is not guaranteed that your doctor’s office will draw the blood in their lab. If you are not attending our blood draw it is your responsibility to coordinate your blood draw with your doctors office, outpatient lab or mobile phlebotomist. Do call ahead to make sure they will do the test and obtain their hours and pricing. Clients that get their blood drawn outside of our office will be responsible for any fees incurred. The kit will then have to be taken right away to a FedEx Express location. There is a prepaid bag inside the MRT kit to send the blood specimen to the lab. Payment for testing can be made to our office when the kit is obtained or by phone or Paypal on the day that the blood is drawn and sent out.

LEAP Package Information

Sessions may vary in length from 30 minutes to 1 hour and can be in person, by phone or videoconference.

I understand that the LEAP dietary protocol only works if I follow the LEAP Elimination diet, as directed, and that the LEAP Therapist will be available to assist me with any questions I may have in a timely manner.

I understand that if I receive my results and wait on starting the LEAP protocol for over 2 months my Certified LEAP Therapist may ask me to retest.

Please allow the Certified Leap Therapist 1 week to design each meal plan. After the phase one items have been chosen at the first session the CLT will create the plan, depending on adjustments the following phase will be created.

I also understand that should I choose not to complete my sessions, I am not entitled to a refund. There is also no guarantee that this program will cure any symptom or disease, and if I don’t follow recommended protocol my results may be compromised. If desired results are not obtained, I am not entitled to any refund.

I understand that most patients see results in two weeks; however, occasionally, patients take longer than 90 days to heal and that if I would like more sessions to continue my treatment, I can purchase more sessions

I choose package option:

Platinum: $4,065 Gold: $3,240 Silver: $2,395 Bronze: $1,645

Signature: ______Date: ______

Payment method: ______

LEAP Package Policies 2016 We take pride in our work and take the responsibility of working with you very seriously. We want to customize your care as much as possible and continue devoting time to furthering our professional repertoire of skills in treating our clients.  I understand that my payment for the LEAP/MRT program includes services not covered by traditional health insurance.  Insurance coverage is not valid for payment. We are happy to provide a receipt for your services, however, reimbursements should be made to the patient or the insurance holder, not to Rebecca Bitzer & Associates. In the event of a mistaken insurance payment to us, the insurance check will be voided and sent back to the insurance company with an explanatory letter.  Extensive email, text or phone communication cannot replace follow-up care, whether scheduled or unscheduled, and the patient will be asked to come in for additional appointments or be referred to a higher level of care.  We will not provide individual receipts for each session, but we will provide you with one receipt that you can submit for out-of network benefits or to a health savings account.  We will not provide insurance companies with additional information such as progress notes from individual sessions.  Appointments are reservations for the dietitian’s time, keeping other patients from reserving that time. Therefore, if you do not attend your scheduled appointment, you will be charged one visit. If notice is given in a timely manner (at least 24 hours in advance of your scheduled appointment), you will not be charged at all. We have a fixed, moderate patient load so we can provide you the best quality of care. We strive to see you on time because we value your time as well as ours.  Phone consultations are available if you are unable to attend the face-to-face scheduled time and will count as one visit.  Appointments must be used within 1 year of signing up for the program.

By signing below, I agree that you have read and understand the above policies. Patient/Guardian Signature______Date______