A patient coming to the doctor gives him/her permission and authority to care for them in accordance with appropriate testing, diagnosis, and analysis. The clinical procedures performed are usually beneficial and seldom cause any problem. In rare cases, underlying physical defects, deformities or pathologies, may render the patient susceptible for injury. The doctor will not provide specific healthcare if he/she is aware that such care may be contraindicated. It is the responsibility of the patient to make it known or to learn through health care procedures from whatever he/she is suffering from: latent pathological defects, illness, or deformities, which would otherwise not come to the attention of the physician.
I agree to settle any claim or dispute I may have against or with any of these persons or entities, whether related to the prescribed care or otherwise, will be resolved by binding arbitration under the current malpractice terms which can be obtained by written request.
Medical, medical weight loss, chiropractic, physical therapy, and massage therapy care, like all forms of health care, offering considerable benefit mat also provide some level of risk. Prior to receiving medical, chiropractic, physical therapy, and massage therapy care in this integrated office, a health history and physical examination will be completed. These procedures are performed to assess your specific condition, your overall health, and your spine health. These procedures will assist us in determining if any further examinations or studies are required. In addition, they will help us determine if there is any reason to modify your care or provide you with a referral to another health care provider. All relevant findings will be reported to you along with a care plan prior to beginning care. I understand and accept that there are risks associated with medical, chiropractic, physical therapy, and massage therapy care and give consent to the examinations that the doctor deems necessary and to the chiropractic care including spinal adjustments, as reported following my assessment.
This notice is effective as of the date signed and will expire seven years after the date on which you last receive services from Gentle Giant Care,
LLC. I have read and understand the foregoing