Sheilagh Durkin, M.S.O.M., L.Ac.

CONSENT TO TREAT WITH HERBAL MEDICINE AND NUTRITIONAL SUPPLEMENTATION

1. Purpose of Treatment

I understand that the practitioner named above provides wellness consultation that may include recommendations for:

• Herbal medicines (botanical preparations, tinctures, powders, capsules, teas)
• Nutritional supplements (vitamins, minerals, amino acids, enzymes, and other nutraceuticals)
• Dietary modifications
• Lifestyle recommendations

These recommendations are intended to support overall health and wellness.

2. Nature of Herbal and Nutritional Therapies

Herbal and nutritional therapies involve the use of natural substances derived from plants,
foods, and nutritional compounds to support physiological balance and well-being.

I understand that:

• Individual responses to herbs and supplements vary.
• Effects may take time to appear.
• Not all effects are fully understood or predictable.

3. Not a Substitute for Medical Care

I understand that:

• The practitioner may not be acting as my primary care physician.
• The services provided are not intended to replace medical diagnosis or treatment by a licensed physician or other qualified healthcare professional.
•  I should consult my physician for medical conditions, diagnosis, or treatment of disease.

4. FDA Disclaimer