Informed Consent
I hereby request and consent to the performance of naturopathic treatments and other procedures within the scope of the practice of naturopathy provided to me at Bribie Acupuncture & Element Fertility & Pregnancy. I understand that naturopathic care may involve the use of clinical nutrition, herbal medicine, nutritional supplementation, lifestyle counselling, and functional or pathology testing. These therapies are intended to support the body’s natural healing processes and improve overall health and wellbeing.
I understand that naturopathic treatment is considered generally safe, but as with any health care treatment, it is important that I am fully informed of the potential risks and responsibilities involved so I may make an informed decision. While side effects from naturopathic treatment are uncommon, I acknowledge that I may experience temporary symptoms such as mild digestive upset, headaches, allergic skin reactions, or fatigue. I also understand that, in some instances, symptoms may temporarily worsen before they improve, which may be a normal part of the healing process. I understand that naturopathic treatment outcomes vary between individuals depending on the condition being treated, and that no specific results can be guaranteed.
Bribie Acupuncture & Element Fertility & Pregnancy adheres to all relevant State and Commonwealth privacy law requirements. All personal and health information I provide will be stored securely and accessed only by clinical and administrative staff for the purposes of treatment and record-keeping. My information will not be disclosed to any third party without my written consent, unless required by law.
I acknowledge that I have had the opportunity to ask questions regarding the nature, purpose, and potential risks of naturopathic care. I understand that while every effort will be made to provide safe, effective treatment, no guarantees have been made as to the outcomes or success of any treatment provided. I understand that I am free to withdraw my consent and discontinue treatment at any time.
Duty of Disclosure
It is my responsibility to inform my practitioner of any changes to my health status, including any new symptoms, diagnoses, test results, or medications. I also understand that it is in my best interest to inform all of my other health care providers, including my medical doctor and/or specialist, of any naturopathic treatments, supplements, or recommendations I am receiving. This ensures that all aspects of my care are considered and helps to avoid any potential interactions or contraindications with existing treatments. Likewise, I understand it is my obligation to keep my naturopath informed of any ongoing or new consultations with other health professionals, as this may affect the treatment plan being developed for me. At times, and only with my permission, it may be necessary for my naturopath to communicate with other health care providers involved in my care to ensure safe and coordinated treatment. However, such contact will not be made automatically and will require my consent.
Consent Declaration
By voluntarily signing below, I confirm that I have read, or have had read to me, the above consent to treatment. I acknowledge that I understand the nature of naturopathic care, the potential risks involved, and the importance of my responsibilities as a client. I have been given adequate time to ask questions, and those questions have been answered to my satisfaction. I intend this consent form to cover the entire course of treatment for my present condition, as well as for any future conditions for which I may seek care. I understand that I may withdraw this consent at any time.