Informed Consent to Care
You are the decision maker for your pet’s health care. Part of my role is to provide you with information to assist you in making informed choices. This process is often referred to as “informed consent” and involves your understanding and agreement regarding the care I recommend, the benefits and risks associated with the care, alternatives, and the potential effect on your pet’s health if you choose not to provide that care.
Chiropractic care centrally involves what is known as a chiropractic adjustment. There may be additional supportive procedures or recommendations as well. When providing an adjustment, I use my hands or an instrument to reposition anatomical structures, such as vertebrae. Potential benefits of an adjustment include restoring normal joint motion, reducing swelling and inflammation in a joint, reducing pain in the joint, and improving neurological functioning and overall well-being.
It is important that you understand, as with all health care approaches, results are not guaranteed, and there is no promise to cure. As with all types of health care interventions, there are some risks to care, including, but not limited to: muscle spasms, aggravating and/or temporary increase in symptoms, lack of improvement of symptoms, fractures (broken bones), disc injuries, dislocations, strains, and sprains. These complications are rare, but are worth noting to you, the owner, so you can be aware of if they do occur.
It is also important that you understand there are treatment options available other than chiropractic procedures. Likely, you have tried many of these approaches already. These options may include, but are not limited to: self-administered care, over-the-counter pain relievers, physical measures and rest, medical care with prescription drugs, physical therapy, bracing, injections, and surgery. Lastly, you have the right to seek a second opinion and to secure other opinions about your pet’s circumstances and health care as you see fit.
By signing below, I understand the following:
· Dr. Kathy Klix is a Doctor of Chiropractic, licensed in the care of humans. She has completed the Essentials Course at Options for Animals College for Animal Chiropractic, education specific to Animal Chiropractic.
· Dr. Klix is also registered with the state of Colorado allowing her to perform Animal Chiropractic without a veterinary referral.
· Dr. Kathy Klix is not a veterinarian and cannot take responsibility for the primary care of my animal.
· Veterinary Chiropractic does not replace traditional veterinary care, but is considered complimentary, and can be used in conjunction with my Veterinarian’s care.
· I understand that some aspects of my animal’s care may be used in future research data.
· Dr. Klix has explained to me the scope of her care and described the procedures she will perform on my animal. I understand them, and acknowledge that they agree with the International Veterinary Chiropractic Association’s (IVCA) description of Animal Chiropractic as follows: “Veterinary Chiropractic is the science, art and philosophy concerned with good health through restoration and maintenance of a properly functioning neuromusculoskeletal system, without the use of drugs or surgery.”
· I understand that my animal’s photograph and name may appear in print ads, Dr. Klix’s Chiropractic website, on social media sites such as Facebook, or any other publications written by Klix Animal Chiropractic.
· Dr. Kathy Klix has explained the risks involved with Animal Chiropractic care to my satisfaction, and I realize that there can be no guarantee as to the nature of my animals’ condition or the outcome of any procedure.
I have read, or have had read to me, the above consent. I appreciate that it is not possible to consider every possible complication to care. I have also had an opportunity to ask questions about its content, and by signing below, I agree with the current or future recommendation to receive chiropractic care as is deemed appropriate for my animal’s circumstance. I intend this consent to cover the entire course of care from Dr Kathy Klix, DC for my animal’s present condition and for any future condition(s) for which I seek chiropractic care.
I also certify that I have been open and honest with Dr. Klix as to any and all other examinations, diagnostic tests, diagnoses, and treatments for my animals’ conditions.
I hereby authorize Dr. Kathy Klix, Chiropractor, to treat my animal with Veterinary Chiropractic.