Please answer the following questions to the best of your ability
I hereby declare that:
I received an explanation regarding the nature of the treatment I am about to receive at my request.
If I suffer from the following diseases: cardiovascular disease, malignant disease, osteoporosis, diabetes, or another disease that impairs function, I declare that I am under medical supervision.
I undertake that in the event of a change in health status, one of the above diseases or conditions will appear or I will start medication and report it to the therapist without delay.
If I do not report the above and I am harmed in any way during or as a result of the treatment, I will be fully responsible and I or anyone in my power will have no claim in this regard against Hila Kay.
I am aware that complementary medicine treatment is not a substitute for medical and/or psychological treatment and/or any conventional medical consultation and that I do not intend to discontinue any pharmacological treatment without consulting my attending physician.
?Do you suffer from one of the problems mentioned here
I declare that the details in this questionnaire form and the health condition in this statement are complete and correct.