This is a Holistic Complementary Therapy and the treatments given are not taking the place of Conventional medicine. You will be advised to seek medical attention when needed. Every effort is made to encourage patients to give full details of any other treatment they have received or are receiving from whatever direction.
By signing this form, you agree that you have read the foregoing notes and confirm that they are a true record. You have not withheld any information which might affect the course of your treatment and you undertake to keep your therapist Informed of any changes in your health and in any prescribed of self-administered medication in order to facilitate an update of this record, when necessary.
The information you have given is strictly Private and Confidential.