Whole System Medicine

This form must be signed before our initial consultation can commence.

As practitioners we utilise the principles and practices of Psychology, Nutritional Psychology, Nutritional Therapy, Traditional Chinese Medicine, Homeopathy and other supportive therapies to assist the body's own ability to heal and to improve the quality of life and health through natural means.

All the above therapies assess the whole person, evaluating mental, emotional and physical health.

Prior to first consultation, you will be asked to complete a detailed holistic health questionnaire, and if you opt for Nutritional Therapy, a 3-day food diary. This is to have a better understanding of your health conditions and how we can best support you to achieve your health and nutritional goals. I understand that some of the questions can be sensitive and these may make you feel uncomfortable, however it is very important that your answers are as accurate as possible and you complete the full questionnaire. Additionally, examinations such as hip to waist or weight measurements (no clothes will be removed) could be taken if needed as well as specific lab diagnostic tests may be required by other health care practitioners you have/are seeing or through private testing laboratories.

By signing this statement of acknowledgment, you understand that:

1. We are a Team of Naturopath/Naturopathic Nutritional Therapist, Psychologist, Homeopath, Microbiologist (PhD), Traditional Chinese Medicine Practitioner (Acupuncture and Herbs ) and NOT a conventional medical doctor (GP Psychology, Naturopathic Nutritional Therapy, Herbalism and Homeopathy are not a substitute for professional medical advice and treatment. Any treatment you receive is not mutually exclusive from any treatment or advice you may now be receiving or may receive in the future from any other licensed health care practitioner.

2. None of us are permitted to diagnose or claim to treat medical conditions.

3. The methods we may use have a proven clinical foundation, yet may not be recognised or accepted by standard (allopathic) medicine.

4. The treatment and/or referral to other health care practitioners is based on the assessment of your health, revealed through personal history, examination, laboratory testing, and any other appropriate method of evaluation. If we believe that your GP or other health care practitioner needs to be contacted or information needs to be shared the contact will be made via you and we will ask for your consent first.

5. Your data will not be shared to any third parties without your consent. Any data to be shared will first be sent to you so that you can review and adjust if necessary.

6. All therapeutic advice/ prescriptions will be tailored to support medically diagnosed conditions and/or health concerns agreed and identified by the parties. Your prescriptions/therapeutic advice programme and supplemental plan will have a time frame and you should not continue with recommendations outside of this unless agreed by our practitioners. This is to avoid any adverse reactions. If you are unclear about any part of your plan then you should contact us immediately for clarification.

7. We reserve the right to discontinue our services where it is apparent that your expectations and what we can provide are not in agreement.

8. We reserve the right to determine which cases fall outside our scope of practice, in which event the appropriate referral will be recommended.

9. You are not an agent of any private or government agency attempting to gather information without so stating your intentions.

10. Changes in dietary habits are not an absolute prerequisite for treatment and you understand that failure to follow sound nutritional, exercise and psychosocial lifestyle programs could undermine any

11. You are accepting or rejecting this care of your own free will.

12. The ultimate responsibility for your health care is your own and that we are here to support you in this. It is important that you tell us about any medical diagnosis you have received, any prescription medication, herbal medicine or food supplements or over the counter medication you are taking as it may affect the nutritional & psychosocial lifestyle programme.

13. You are responsible for contacting your GP or specialist about any health concerns you may have. Please advise your GP or specialist of the nutrition & psychosocial lifestyle protocol, herbal and homeopathic treatment you will be following. Please also advise any other complementary medicine practitioners you are consulting.

14. We also recognise that even the gentlest therapies, supplements and medications potentially have their complications in certain physiological conditions, in very young children, in those on multiple medications, in pregnancy, while breastfeeding and hence the information provided is complete and inclusive of all health concerns including risk of pregnancy; all medications, including over the counter drugs and supplements. The slight health risk of some treatments include, but not limited to: aggravation of pre-existing symptoms, allergic reaction to supplements or herbs; pain, fainting, bruising or injury from

15. Understanding that you will need to complete a holistic health questionnaire and a 3-day food diary and return them at least 4 days prior to your appointment. This will allow us to have enough time to go through into detail your personal history and understand your health and nutritional aims. This is also for you to benefit your time with us in consultation as much as possible. However, you can decide to complete these during our first consultation at your own responsibility.

16. Supplementation may be recommended in your plan but you can choose to not follow it. If you agree to follow our supplemental recommendations you will be offered an Email Cart to Client service provided by the Natural Dispensary website. Other alternative purchasing options can be also discussed or offered.

17. Notice of at least 48 hours is required for appointment rescheduling or cancellations. Please note that a fee of £40 will be also charged for late cancellations and missed appointments.

18. Under the General Data Protection Regulations (GDPR), we are required by law to inform you that any data pertaining to you will be kept in an encrypted, secure, cloud-based storage for 7 years under a code rather than your name, and after this date it will be destroyed. This is required by our professional liability insurer and our professional organisations like the HMRC, ARH and SOH.

 

Initial Payment

Prior to the commencement of your first appointment please pay an initial installment of £233 made payable to: 

Louisa Alison Habgood  

Sort code: 04-00-04
Acc/n:o 26430258
Monzo Bank

Terms of Engagement and Informed Consent

I, the undersigned, have read, understood and acknowledged the Whole System Medicine Terms of Engagement and Informed Consent.