Client services and chart information are confidential. Written authorization is required from you to release any information.
Even the gentlest therapies may cause complications in certain physiological conditions this depends greatly on the individual and the extent of the illness. Some therapies must be used with caution in certain diseases such as diabetes, heart, liver or kidney disease.
It is very important, therefore, that you inform your Naturopathic doctor immediately of any disease process that you are suffering from as well as any medications (prescription or over-the-counter) that you are taking. If you are pregnant, suspect you are pregnant, or you are breastfeeding, advise your doctor immediately.
• Your scheduled session is set aside for you. We do not double book appointments
• Please reschedule your session if you are more than 15 minutes late
• 24 hour cancellation notice is required to avoid being charged for 50% of your session, as we are a busy clinic and our time is sort after.
• Inappropriate behaviour will not be tolerated and may be prosecuted to the full extent of the law
Statement of Acknowledgement
In order to clarify our position as healthcare practitioners and our mutual responsibilities in your health care, we ask for your cooperation in signing this statement of acknowledgement.
1. That you understand that Naturopathic practitioners are not Medical Doctors; that we use non-invasive, natural methods of assessment and treatment of body dysfunctions.
2. That you understand that treatment and/or referral to other health practitioners is based
upon the assessment of your health revealed through personal history, physical examination, laboratory testing and other appropriate methods of evaluation.
3. That you understand that the ultimate responsibility for your health care is your own and that we are here to support you in this. We reserve the right to discontinue our services where it is apparent that your expectations and what we provide are not in agreement.
4. I understand that a record will be kept of health services provided to me. This record will be kept confidential and will not be released to others unless you give your consent or the law requires it.
5. I understand that my Naturopathic doctor will answer any questions to the best of her ability. I understand that results are not guaranteed. I do not expect my Naturopath to be able to anticipate all risks and complications, such as allergic reactions to supplements and herbs. I will rely on my Naturopathic doctor to exercise judgment during the course of the procedure, which they feel at that time is in my best interests based on the facts then known.
6.I understand that Naturopathic and Nutritional practitioners do not diagnose illness, disease, any physical or mental disorder, nor do they prescribe medical treatment, pharmaceuticals, or perform joint mobilization.
With this knowledge, I voluntarily consent to diagnostic and therapeutic procedures mentioned above
I understand this consent form to cover the entire course of my treatment for my present condition. I understand that I am free to withdraw my consent and to discontinue participation in these procedures at any time.
By my electronic signature below, I agree to the policy and client agreement above.