Four Requests in One Session
You are an independent contractor at a commercial gym, paid per session, with your own liability insurance. A client, Priya, 38, wants to lose 30 lb. In one session she asks you to (a) write her a 1,200-kcal/day meal plan with specific meals, (b) tell her whether a "fat-burner" supplement she bought online is safe with her antidepressant, (c) post her before-and-after photos on your business Instagram, and (d) check her pulse because she has been having palpitations at rest since Tuesday. Your contract with the gym says all client photos require the gym's marketing approval, and the gym's release form is separate from your own.
1. Sort these four requests into what you can do, what you must refer, and what you must refuse, and explain the boundary for each.
Read the worked answer
(a) Meal plan - refer. A 1,200-kcal prescription with specific meals is medical nutrition therapy. I can give general education (portion awareness, protein at meals, limiting sugar-sweetened drinks) but not a calorie-prescribed plan. Refer to a registered dietitian. If she pushes, say: "I can coach habits; a dietitian can safely set the numbers."
(b) Supplement safety with an antidepressant - refuse and refer. I do not evaluate interactions or supplement safety. That is her pharmacist or prescriber. I can note what she is taking in her file and ask her to clear it with them. Do not say "it's probably fine."
(c) Photos - can do only with proper written consent and gym approval. Both my release and the gym's marketing approval are needed. The release must state the specific use (Instagram, website), whether her face is shown, that she can revoke it, and how long the images will be used. No misleading claims ("lost 30 lb in 3 weeks").
(d) Palpitations - refer now, do not "check her pulse and tell her it's okay." Resting palpitations since Tuesday are a symptom that needs medical evaluation. I may record a pulse as an observation, but I cannot diagnose or clear her. If she has chest pain, fainting, or severe shortness of breath, that is emergency care.
2. Draft the consent conversation for the photos, including what you would put in writing and what you would not post.
Read the worked answer
Conversation: "I'd be glad to, but I want to do it properly. The gym requires marketing approval, and I use my own photo release. You can say yes now and change your mind later - I'll take them down. Do you want your face in them or just your body?"
In writing:
- Client name, date, and signature.
- Specific platforms and specific images (or a described set).
- Whether face/identifying features are included.
- That consent is voluntary, not a condition of training, and revocable in writing.
- That no specific weight-loss result is promised.
- A statement that the gym's marketing team also approved the use, per the contractor agreement.
What I would not post: before/after photos with a time frame implying rapid or guaranteed results; photos with her face if she only consented to cropped images; anything showing the gym's branding without approval; anything posted after she revokes consent.
Also: keep a copy of the release and the gym's approval in the client file, not just in my phone.
3. What do you do about the palpitations in the moment, and what goes in the record?
Read the worked answer
In the moment: stop the planned intense work. Ask about chest pain, fainting, severe shortness of breath, and whether this is new. Record a resting pulse and BP if available, but do not tell her "your pulse is fine" or "it's just anxiety." Advise her to contact her physician or urgent care today; if she has chest pain, syncope, or marked breathlessness, call emergency services.
Record: date and time; her words ("palpitations at rest since Tuesday"); associated symptoms; vital signs taken; that exercise was modified or stopped; that she was advised to seek medical evaluation; her response; and follow-up plan.
Do not record a diagnosis. Write "reported palpitations" not "PVCs" or "anxiety attack."
Business layer: as an independent contractor, I confirm my own liability coverage responds to this session, keep my own client file in addition to the gym's, and notify the gym manager if an incident report is required. If she is not cleared, I hold training until she brings written clearance.