Terms of Engagement and Informed Consent
This form must be read before our initial consultation can commence.
As a practitioner I utilise the principles and practices of Homeopathy, Microbiology, Herbal medicine, and Holistic Counselling to assist the body’s own ability to heal and to improve the quality of life and health through natural means.
All the above therapies assess the whole person, evaluating mental, emotional and physical health.
Prior to first consultation, you will be asked to complete a detailed holistic health questionnaire. This is to have a better understanding of your health conditions and how I can best support you to achieve a balanced state of health. I understand that some of the questions can be sensitive and these may make you feel uncomfortable, however it is very important that your answers are as accurate as possible and you complete the full questionnaire. Nevertheless, if you rather not, we can do it throughout consultation.
By agreeing this statement of acknowledgment, you understand that:
- I am a Homeopath DIHom (Pract), Microbiologist (PhD), Holding a BSc in Food Engineering, a MSc in Food Microbiology and NOT a conventional medical doctor (GP). Homeopathy, Microbiology, Herbal medicine, and Holistic Counselling are not a substitute for professional medical advice and treatment. Any treatment you receive is not mutually exclusive from any treatment or advice you may now be receiving or may receive in the future from any other licensed health care practitioner.
- I am not permitted to diagnose or claim to treat medical conditions.
- The methods I may use have a proven clinical foundation, yet may not be recognised or accepted by standard (allopathic) medicine.
- The treatment and/or referral to other health care practitioners is based on the assessment of your health, revealed through personal history, examination, laboratory testing, and any other appropriate method of evaluation. If I believe that your GP or other health care practitioner needs to be contacted or information should be shared, the contact will be made via you and I will ask for your consent first.
- Your data will not be shared to any third parties without your consent. Any data to be shared will first be sent to you so that you can review and adjust if necessary.
- All therapeutic advice/ prescriptions will be tailored to support medically diagnosed conditions and/or health concerns agreed and identified. Your prescriptions/therapeutic advice programme and supplemental plan will have a time frame and you should not continue with recommendations outside of this unless agreed by me. This is to avoid any adverse reactions. If you are unclear about any part of your plan then you should contact me immediately for clarification.
- I reserve the right to discontinue my services where it is apparent that your expectations and what I can provide are not in agreement.
- I reserve the right to determine which cases fall outside my scope of practice, in which event the appropriate referral will be recommended.
- You are not an agent of any private or government agency attempting to gather information without so stating your intentions.
- You are accepting or rejecting this care of your own free will.
- The ultimate responsibility for your health care is your own and that I am here to support you in this. It is important that you tell me about any medical diagnosis you have received, any prescription medication, herbal medicine or food supplements or over the counter medication you are taking.
- You are responsible for contacting your GP or specialist about any health concerns you may have. Please advise your GP or specialist of the nutrition, herbal and homeopathic treatment you will be following. Please also advise any other complementary medicine practitioners you are consulting.
- I also recognise that even the gentlest therapies, supplements and medications potentially have their complications in certain physiological conditions, in very young children, in those on multiple medications, in pregnancy, while breastfeeding and hence the information provided is complete and inclusive of all health concerns including risk of pregnancy; all medications, including over the counter drugs and supplements.
- Understanding that you will need to complete a holistic health questionnaire and return it at least 2 days prior to your appointment. This will allow me to have enough time to go through into detail your personal history and understand your health and nutritional aims. This is also for you to benefit your time with me in consultation as much as possible. However, you can decide to complete these during our first consultation at your own responsibility.
- Supplementation may be recommended in your plan but you can choose to not follow it.
- Notice of at least 24 hours is required for appointment rescheduling or cancellations. Please note that a fee of £40 will be also charged for late cancellations and missed appointments.
- As from 25th of May 2018, under the General Data Protection Regulations (GDPR), I am required by law to inform you that any data pertaining to you will be kept in a encrypted secure cloud-based storage for 7 years under a code rather than your name, and after this date it will be destroyed. This is required by my professional liability insurer and my professional organisations Society of homeopaths (SOH).
Terms of Engagement and Informed Consent
By ticking the box in the website you are agreeing to the Terms of Engagement and Informed Consent .
I appreciate the time spent reading these terms of engagement and completing the relevant form.
Email: firstname.lastname@example.org Website: alexcmelo.com