INFORMED CONSENT AND FULL DISCLOSURE DOCUMENT

DBA Wildflower Clinic under Hutchinson Holistics LLC.

The purpose of this document is to clearly delineate the scope of practice assumed by Dana Hutchinson from Hutchinson Holistics LLC and DBA the Wildflower Clinic to ensure that no misunderstanding occurs between herself and any clients as to the expected course or progression of herbal therapeutics. 

The State of Colorado does not at this time license Herbalists. Dana Hutchinson is a registered herbalist with the American Herbalists Guild (the highest accreditation possible for practicing clinical herbalists), is not a medical doctor, and does not claim to diagnose, treat, cure, or prevent any medical condition or pathology nor prescribe medicine nor in any way represent herself as doing so. For any medical condition, you are advised to seek care from a legal medical doctor or physcian. Whether you choose to engage with a medical doctor or not for your care is your right, and Ms. Hutchinson assumes no responsibility for your decision in this matter. The FDA has not evauated her services or products. Her services and products do not intend to treat, diagnose, cure, or prevent any disease.

In accordance with the Senate Bill 13-215 in the State of Colorado, The Wildflower Clinic and Dana Hutchinson offer no surgical procedures, no prescribed drugs, no X-rays, no controlled prescribed substances, no THC, no spinal or pharmaceutical anesthetics, no lasers, no radioactive substances, no invasive treatments, administers no enemas or colonic hydrotherapy procedures, performs no midwifery, no psychotherapy, no optometry, no massage services and no chiropractic services. We do not work with children under the age of 8, we do not directly administer medical protocols to a pregnant woman or a client with cancer, we do not provide conventional medical diagnosis to a client, and we do not recommend the discontinuation of a course of care, including a prescription drug, that was recommended or prescribed by a health care professional.  

 I, the undersigned, assume all responsibility for decisions I make regarding my health, recognizing that (a) no claims are made for herbal medicine, nutritional or dietary recommendations to treat or cure any medical condition (b) all information given is for educational purposes only (c) there is no implied or stated guarantee of success or effectiveness of any specific nutrition plan,  treatment plan, or guidelines (d) I am free to act upon or disregard the recommendations of Dana Hutchinson as I so choose. I hereby release Dana Hutchinson from all responsibility for my actions and any consequences thereof in the present time and in the future with no constraints. I hereby affirm that I consent and agree to the above statements of my own free will and request to engage the services of Dana Hutchinson in a professional relationship pursuant to the statements herein.

Lead Herbalist: Dana Hutchinson MA, RH (AHG), BCMH, CTCMP

Qualifications:

• Owner & Lead Clinical Herbalist- Wildflower Clinic 
• Advisory Mentorship Council- American Herbalist Guild (AHG)
• RH- Registered Medical Herbalist- American Herbalist Guild (AHG) 
• Board Certified Medical Herbalist (AANWP)
• Board Certified Holistic Health Practitioner (AADP)
• Faculty- Colorado School of Clinical Herbalism
• Certified Clinical Herbalist- Colorado School of Clinical Herbalism
• Certified Advanced & Western Medical Herbalist- North American Institute of Medical Herbalism (NAIMH)
• Certified Chinese Herbologist- Institute of Chinese Herbology 
• Certified Reiki Practitioner (Level III)- Body Mind Energy Center 
• Certified Flower Essence Practitioner- Heart of Herbs Herbalism School
• Certificate in Plant-Based Nutrition- Cornell University 
• Certificate in Rocky Mountain Field Botany- Colorado School of Clinical Herbalism
• Registered Yoga Teacher- Yoga RYT 200hr- Cascade School of Yoga
• Certficate in Raw Food Living- Anne Wigmore Natural Health Institute 

AGREEMENT TERMS & CONDITIONS

Philosophy of Practice

The Wildflower Clinic practices holistic, natural health care with botanical medicines. This approach allows our clinic to address each client under a unique light. We truly believe that each individual has a different presentation and requires a completely customized herbal protocol. There is no "one pill fits all" perspective in herbal medicine. Our reccomendations can include comprehensive supplements, energetic Qi exercises, Emotional Freedom Technique practices, Qi Gong remedies, and potent clinical herbal protocols. The Wildflower Clinic desires to foster a sense of wholeness in our clients and we will heavily encourage their new deep connection to the plant world. We encourage clients to create a healing team around themselves and actively engage in the healing process in order to achieve the best progress on their wellness journey. 

What to expect in an initial consultation

Your first intake lasts 120 minutes (2 hours). Extensive intake forms are completed first by the client, and submitted ahead of time for us to review. In the session, we will discuss current health concerns, past medical history, family health, diet and exercise habits, emotional well-being, and state of mind. We will review any medical diagnosis and work with you to determine how best to approach the health concerns. We will be reading your pulse, your tongue, your nails, and your skin in addition to recording your emotional status. From this case review, we will evaluate the reccomended priorities and create a customized protocol of herbs, tinctures, supplements, nutritional programs, and alternative therapy work. Our clinic does have certified training in reiki energy healing, flower essences, and other energetic systems of health and healing, which can be used in your protocol to assist your health transformation. 

Dispensary procedures

If you are a local client, you will be able to pick up your herbs 5-6 working days after your appointment day. Your formula descriptions will be emailed to you, and it is your responsibility to ask any questions you may have about your herbal protocol. Most nutritional supplements recommended will be ordered from your Fullscript account online, which will ship to your house. If you are out of state or fly in for the visit, then we will ship herbs to you at their nominal charge 5-6 working days after your session takes place. 

What to expect in a follow up consultation

Follow up visit are 35 minutes- 1 hour depending on the condition being treated and the time needed to monitor the progress of the patient's health. Follow up sessions are usually held every 2-4 weeks depending on the health issues we are working on. Most client's will need at least 8 follow up sessions to begin to see full-body transformation in their health. In these sessions we will evaluate the progress, discuss any problems or concerns that have arisen, and review the herbal protocols.

What are the costs?

The cost of an initial 120 minute (2 hour) intake session is $248.50/ hr. USD ($497 Total) and includes Chinese diagnostic testing, a complrehensive health history overlook, the drafting of your customized wellness protocol, a copy of our 6 week elimination diet E-book, all supplemental educational resources pertaining to your health symptoms, plus access to Dana Hutchinson's email correspondence (10 minutes in between each session). Follow up visits are $150.00 USD flat fee for a 35 minute- 50 minute session.

Custom herbals protocol items are priced below and are not included in the consultation price:

• Custom wildcrafted leaf + flower infusion (month supply) from $89.00 USD
• Custom root, berry + bark decoction (month supply) from $99 USD 
• Custom TCM medicinal tincture (2 oz.) from $62.00 USD
• Custom TCM medicinal tincture (4 oz.) from $99.00 USD 
• Custom medicinal salves, sprays and oils from $69.00 USD

*Costs for complicated & chronic conditions may be outside these price windows. If you are taking any medications or engaging in other prescription treatments prescribed by a physician, it is important that Ms. Hutchinson knows the nature of these medications and that they are disclosed to her. Additionally, you should check to determine that any herbs taken in any dose will not cause a negative reaction with your current medications. 

Reimbursement

Herbal medicine is not yet covered by general insurance in the State of Colorado. For those with extended medical coverage we recommend that you keep your receipts and try to claim it – some people have been fortunate to receive reimbursements. If you are self-employed you may be able to write it off – ask your accountant. We also take all HSA/ FSA cards. 

Client redress

As professional and board certified herbalists, it is our duty and responsibility to provide you with the best health care information and support that is possible. If you have any problems or are in some way unsatisfied with your experience here, please let our clinic know immediatley.  

Cancellation Policy 

In order to respect our time as clinicians with our clients, we require a cancellation or re-schedule of an appointment 48 hours before the session takes place. No show appointments will be charged the flat appointment fee. Appointments cancelled inside the 48 hour window period will be charged $100.

 

 *This statement from the Wildflower Clinic and Dana Hutchinson has not been evaluated by the Food and Drug Administration. The Wildflower Clinic does not intend to treat, diagnose, cure, or prevent any disease. Dana Hutchinson is not a medical doctor and guides her clients through educational information only.

Client Signature ("sign" with mouse)

PLEASE READ AND SIGN ONCE YOU HAVE AGREED:

1. I understand that my intake fee includes general email support (10 minutes in between sessions). If the practitioner decides that more time is needed to research my questions via email in between sessions, then an additional $50 USD per 10 minutes of research and or time will be billed to you.

 

2. I agree to only contact the lead medical practitioner or Wildflower Clinic clinicians via email. I understand that Dana and her team have myriads of other clients, and I should expect at least 3 business days for an email response. 

 

3. I understand that Dana Hutchinson's practice does not operate on an urgency basis and she should not be contacted in the case of a health emergency or complication. I understand that the Wildflower Clinic is not a replacement for a Primary Care Physician (PCP), a General Physician (GP), an OBGYN, Licensed Psychotherapist, or a walk in emergency medical clinic. 

 

4. I understand that most health conditions require a minimum of 6 months of herbal treatment, supplementation, and energetic remedies before results can be seen.

 

5. I understand that taking my recommended herbal formulas and results go hand in hand. I understand that in order to see results, I need to take the correct dosage of my herbal formulas as directed by my lead medical practitioner or clinician. I also understand that although herbal medicine is known to achieve significant health results across a variety of conditions, my health condition (s) may require more comprehensive protocols and or combination treatments with additional alternatives practitioners in order to see results.