I hereby declare that I have answered the consultation fully and I have not withheld any information that may affect the outcome of the treatment. I know of no reason why I cannot undertake the treatment. It is my responsibility to notify the therapist of any medical changes that may affect any treatment either now or in the future.
I hereby authorize Laura Gil to gather all the necessary details needed for my appointment to ensure the safety of both the patient and the therapist.
The personal information you provided will be securely saved to meet GDPR regulations and will only be kept and used by Laura Gil for insurance purposes as well as to help plan safe and effective treatments. The personal information enclosed during your treatments is strictly confidential and will not be shared with any third parties without your prior consent.
I understand that the treatments I am receiving are complementary therapies and are not a substitute for medical care. I understand that practitioners do not diagnose conditions, nor do they prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of a licensed medical professional.
If you experience any medical condition and have not seen your doctor yet, I recommend you to do so today.