Consent
You understand that Theaj Niehhar providing the homeopathic consultation is under supervision, a third-year student at the School of Homeopathy, UK, and is not a licensed medical doctor.
You understand that homeopathic case intake does not involve diagnosis of medical conditions. You acknowledge that it is your responsibility to seek a medical doctor for diagnosis and advice for present and future health conditions.
In a homeopathic consultation, you are exercising your right to choose a complimentary/alternative method of treatment through which to address your total health.
It is your responsibility to consult a qualified medical doctor in the event of an emergency.
You acknowledge that homeopathy may occasionally cause aggravations and returning of previous symptoms as body’s innate way to heal layers of the chronic disease. Generally, low potency lessens or removes aggravations.
You understand that homeopathy views health and illness in a holistic manner and that this view is different from the standard, conventional approach, which usually limits its concerns to isolated symptoms. You understand that homeopathy regards the mental, emotional and physical aspects of an individual as important. Improvement in health will be evaluated from a total view of all these areas.
The contents of the website, homeopathycircle.com are for information purposes only to understand homeopathic philosophy. It is not intended to diagnose, cure or prevent any disease or act as a substitute for a face-to-face consultation with a qualified medical doctor. Such information should not be construed as medical advice.
If you have any questions regarding your treatment, I am contactable by email on weekdays and will reply within 48 hours.
You understand that appointment reminders are sent by email as a courtesy, and that it is your responsibility to make a note of the appointment date and time, and give at least 24 hours’ notice if you need to reschedule.
You agree to forfeit the fees incurred for missed or cancelled appointments without 24 hours’ notice.
All refunds will be processed back to the credit card with which the purchase was made via PayPal. Associated payment processing fees will be the responsibility of the client.
While I provide homeopathic expertise and care, your health and well-being are ultimately your responsibility.
You acknowledge that you have read and understood the homeopath/patient agreement.
You agree to homeopathic treatment with Theaj Niehhar, and authorize discussion of your case notes particularly with homeopath supervisor, Pat Deacon.
Confidentiality Agreement
You have rights regarding your personal data, including knowing what information I have on record about you.
Your personal information is used to analyse the conditions and symptoms to prescribe homeopathic remedies.
Any information communicated by the patient or colleagues, including case history, case file, and any written case notes shall be held as confidential, except as follows:
- In response to a valid court order.
- In an emergency or other dangerous situation, where in the professional opinion of the homeopath and based on legal advice pertaining to the provincial jurisdiction, the information may assist in prevention of possible injury to the patient or to another person, such as if there is reasonable suspicion of child or elder abuse or that that the patient presents danger to him or herself or to others.
All patient files including notes, and forms shall be kept in a locked filing cabinet. Furthermore, all electronic files shall be fully password-protected with an encrypted security key.
I shall not transmit or reveal to a third party any information contained in the patient case records or obtained during the practitioner-patient interaction, without the patient’s informed and signed agreement as to the nature and extent of the disclosure.
I shall obtain informed and signed consent from the patient in order to make use of any part of the patient’s case history, notes, or file for the purposes of teaching, publishing, or research.
Your information is stored for as long as you continue to receive consultations. Since patients frequently return for additional consultations after an absence, your information will be securely stored for sixteen years following your last visit. At that time, your file will be securely deleted, and all digital data will be wiped from the computer system.
Your email address and any personal information transmitted by email are stored securely on the servers of my email service provider using a login-specific security key.
Signature: ________________________________________________
(Patient or Parent/Guardian if the patient is under the age of consent)
Date: ________________________________________