Homeopathy is a form of medicine based on the Law of Similars — that is, the use of tiny doses of the very thing that causes symptoms in healthy people. These minute doses of plant, animal, or mineral origins are used to stimulate the body's ability to heal itself. Homeopathy is a powerful tool that effects healing on a physical and emotional level
Lifestyle counselling involves identifying risk factors and making recommendations to help optimize one's physical, mental and emotional environment.
During your initial visits, your Homeopath will take a thorough case history, and any physical examination needed.
Please initial the following:
I understand that a record will be kept of the health services provided to me. This record will be kept confidential and will not be released to others without my
consent, unless required by law. I understand that I may look at my medical record at any time and can request a copy of it by paying the appropriate fee.
I understand that the homeopath will answer any questions that I have to the
best of their ability. I understand that the results are NOT guaranteed. I do not expect the homeopath to be able to anticipate and explain all risks and complications. With this knowledge, I voluntarily consent to the procedures mentioned above, except for (please
list any exceptions):
I understand that charges are to be paid at the time of the visit unless specific arrangements have been made. (Initial Consultation $100.00) (Follow-up visits up to 45 minutes $ 50.00) Payment for all dispensary items is due at the time they are received. As the patient, you are responsible for the total charges incurred for each visit. If you have coverage for Homeopathic Medicine through an insurance company, you are responsible for billing your own insurance company.
I have read and understood the above-stated information and policies. I intend this consent form to cover the entire course of treatment for my present condition. I understand that I am free to withdraw consent and to discontinue participation in these treatments at any time.
Homeopathy views health from a holistic perspective. Homeopaths do not make any sort of diagnosis in medical terms and it is your responsibility to maintain a relationship with a licensed physician or primary care provider for appropriate evaluations and check-ups.
***Under no circumstances should any suggestions be taken as a medical diagnosis or direction against a licensed medical or mental health care professional. ***
By agreeing to our terms of service you agree to the following:
I waive all legal rights that may arise from the homeopathic treatment and hold the assignedHomeopath harmless from all claims, present, and future, known or unknown, in any manner arising out of the homeopathic treatment.
The Parties agree that the terms and provisions of this Agreement embody their mutualintent and that such terms and conditions are not to be construed more liberally in favor of,or more strictly against,either Party.