Terms of Engagement & Consent Form
Poynton Holistic Clinic/The Naturopathic Nutritional Practitioner
- A 50% deposit is required at time of booking. This deposit is non-refundable however, the appointment may be rescheduled up to 3 times if necessary.
- Naturopathic nutritional advice will be tailored to support medically diagnosed conditions and/or health concerns agreed and identified by the two parties.
- Naturopathic nutritional practitioners are not permitted to diagnose or claim to treat medical conditions.
- Naturopathic nutritional therapy is not a substitute for professional medical advice and treatment.
- The nutritional practitioner may receive commission from the sale of supplements however, recommendations made will always be based on perceived client requirements.
- You are responsible for contacting your GP or specialist about any health concerns you may have.
- Please advise your GP of the naturopathic nutrition protocol you will be following. Please also advise any other complementary medicine practitioners you are consulting.
- It is important that you tell your practitioner about any medical diagnosis you have received, any prescription medication, herbal medicine, food supplements or over the counter medication you are taking as it may affect the naturopathic nutritional programme.
- If you are unclear about any part of your wellness plan then you should contact your practitioner immediately for clarification.
- Your naturopathic nutritional programme and supplement plan will have a time frame and you should not continue with recommendations outside of this unless agreed by your naturopathic nutritional practitioner. This is to avoid any adverse reactions.
- Please report any concerns about your programme to your naturopathic nutritional practitioner for discussion at your next consultation.
As part of your healthcare:
Poynton Holistic Clinic may share your sensitive information with third parties to support your ongoing healthcare. If we do not receive this consent from you, we will not be able to coordinate your healthcare with that provided by other providers which means the healthcare provided by us may be less effective.
Please tick the appropriate boxes to confirm your consent:
- I consent to my sensitive information being shared with other healthcare providers, whose details I have provided
- I consent to my sensitive information being shared with my GP if appropriate
We may also share your contact information with biochemical testing companies to order tests as part of your healthcare, some of which maybe from outside of the European Union. If we do not receive this consent from you, we will review alternative tests from providers based within the European Union.
Please tick the box to confirm your consent:
- I consent to my contact information being shared with biochemical testing companies outside of the European Union
You can withdraw your consent to the above at any time by emailing Poynton Holistic Clinic.
Marketing and information
Poynton Holistic Clinic would like to contact you occasionally by email with promotional offers, information on upcoming events and activities, and newsletters.
Please tick the appropriate box to confirm your consent to be contacted for these purposes:
- I would like to receive regular newsletters
- I would like to receive promotional offers and information on upcoming events and activities.
You can withdraw your consent to the above communications at any time by emailing Poynton Holistic Clinic.
Poynton Holistic Clinic seeks to continuously improve our practice through professional development, a key part of which is sharing case histories with our peers through clinical supervision, online forums and discussion groups. Your name, address and contact details will never be shared.
If you are happy for us to use your data for this purpose, please tick the box below to confirm your consent:
- I consent to my data being used for the purpose of professional development:
Poynton Holistic Clinic would like to share your case history with peers for educational purposes. This could be through conferences, lectures, online forums, and publishing in medical journals, trade magazines or online professional sites. Your name, address and contact details will never be shared.
I consent to my data being used for educational purposes. Please tick the appropriate box to confirm your consent:
- Online forums
- Medical journals
- Trade magazines
- Online professional sites
You can withdraw your consent to the above at any time by emailing email@example.com
Signature ……………………………. Date……………………………………