Consent – Naturopathic Medicine Form – Essential Healthcare Australia

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ABOUT Naturopathic Medicine Practice

Naturopathic Medicine is a form of wholistic healthcare consultation that utilises herbal medicines, nutritional supplements, dietary modifications and lifestyle education. Naturopathic Medicine works in collaboration with Orthodox Medical practitioners (GP’S) to bring about therapeutic changes to improve health and wellbeing.

Therapeutic methods include:

Nutritional Medicine focused to identify dietary anomalies and support restorative measures through dietary and lifestyle interventions. Nutritional and metabolic care may involve dietary and lifestyle counselling, modification and education that underpins the relationship between food and disease.

Orthomolecular Medicine uses prescriptive supplementation of micronutrients in the focus of disease prevention and treatment.

Medical Herbalism prescribes herbal medicines including teas, liquid herbs, tablets and capsules in the treatment and prevention of disease maintenance

Clinical Aromatherapy utilises various concentrated plant extracts in the form of essential oils to influence therapeutic outcomes

Iridology / Iridiagnosis is a diagnostic tool that engages iris observation to identify opthalmic cellular changes that are reflected within the body. Iridology can also be used to identify psychological profiling

Flower Essence Therapy supports positive therapeutic outcomes of emotional harmony and balance through the use of subtle floral medicines

Nail Analysis is the observation of the nail bed to identify nail anomalies and signs that can determine cellular changes within your body and your health status

I acknowledge I have read and understand the various practices used within naturopathic medicine

Naturopathic Medicine Principles

First Do No Harm (Primum Non Nocere) At the core, all medical practice is to assure that therapeutic procedures and practices contain safe and effective client outcomes.

The Healing Power of Nature (Vis Medicatrix Naturae) Naturopathic practice recognizes, respects and promotes the innate healing value of nature in each person.

Identify and Treat the Cause (Tolle Causam) To identify the underlying cause of dysfunction and disease and eliminate the obstacles to heal

Doctor as Teacher (Docere) The practice to elevate health and wellbeing independence by means to educate, inspire and facilitate effective change in lifestyle and adaptive habits and catalyse self empowerment.

Treat the Whole Person (Tolle Totum) To understand the whole spectrum of human interconnectedness whilst collaborating all individual health factors and influences on total health.

Prevention (Praevenic) The practitioner is concerned not only with recovery from disease, but equally with maintenance of health and wellness.

I acknowledge I have read and understand the principles of naturopathic medicine practice

WHAT TO EXPECT during a consultation

During your consultation, your naturopathic practitioner will guide your through a thorough medical history that may include

Personal, social, medical, lifestyle and dietary components

Performance of physical examinations and assessments

Referral to medical professionals for investigation such as blood tests or request previous copies of tests to identify anomalies and/or contributing factors that may be impacting your health.

Disclosing information regarding all medical conditions and/or condition is paramount to enable your practitioner to formulate a safe treatment plan that will not interact with orthodox medications prescribed by your GP or over the counter medications.

Please advise your practitioner if you intend to become pregnant, are pregnant, nursing, or become pregnant throughout the course of your naturopathic treatment.

In consultation, you will receive all relevant information regarding your consultation, treatment plans, dietary education and modifications, alternative courses of action, fees and costs, benefits, risks, side effects and consequences of non-compliance upon health and wellbeing.

You may experience change, depending upon the nature of your health presentation. Change may be experienced at one level to effect transformation on another. Personal transitions can take the form of emotional, cognitive, behavioural and/or spiritual modification. Change management is designed to ensure that reframing and/or reconstruct is implemented in a supported environment that safeguards concrete and successful transitions to result in adoption of change.

I acknowledge I have read and understand the expectations of a naturopathic medicine consultation

INFORMED CONSENT

Please "tick" each box to indicate that you have read and acknowledged the following:

I give consent / agree that:

The consultation is designed to gather information for clinical purpose to formulate customised treatment plans aimed to achieve desired therapeutic outcomes
My health information is recorded in a medical file and will not be released to others unless so directed by myself or if law requires
Services provided to me are under the instructions of the treating Health Practitioner
My health information may be shared and discussed between other healthcare providers for medical support
My intake form is completed prior to consultation and all information is honest, accurate, current and true
Details of any/all medical condition(s) and medical history, including any changes in my personal or health details, are fully disclosed.
Results may not always be guaranteed
In the event of emergency or other, I consent to the release of my medical information to my contact support person as listed above
I have read / or will read the information regarding consultation, assessment and treatment, accessible under the "consultation" menu on EHA's website, to keep me informed of my consultation, treatment, therapeutic objectives and outcome goals.

By signing this form, I give my consent to a Naturopathic Medicine Consultation, including Nutritional and Western Herbal Medicine, and Customised Treatment Plan

Client Signature Guardian Signature (If applicable)