INFORMED CONSENT FOR NATUROPATHIC MEDICINE
Naturopathic Medicine is considered a primary health care service in British Columbia, designed to be used in conjunction with your regular primary care medical service providers. It focuses on individualised treatment, the prevention of disease, and the choice of less harmful (or more “natural”) treatments. Naturopathic interns and physicians assess the whole person, taking into consideration physical, mental, emotional and spiritual aspects of the individual. Naturopathic physicians are licensed to diagnose and treat illness. We provide a wide range of treatment options, which may include, but not limited to nutritional and lifestyle counselling, botanical medicine, physical therapies, acupuncture, spinal manipulation, homeopathy, laboratory diagnosis, supplements, vitamins, and pharmaceutical prescriptions in order to stimulate the body’s inherent healing capacity. We are governed by the Health Professions Act of BC and the Canadian College of Naturopathic Physicians of British Columbia (CNPBC).
Our Naturopathic interns and physicians like to take time with people to cultivate a doctor-patient relationship that is built on mutual trust and respect. While it is possible for some treatments to be rapid and effective on the first visit, naturopathic treatment often requires repeated visits. The course of treatment is always discussed and individualised to your needs. While we do a very comprehensive intake, we do not monitor all health conditions and require that you have a primary care physician to monitor any conditions not being actively addressed by your naturopathic care team, and that your primary care physician will attest that these conditions are stable.
Informed Consent for Specialised Treatments:
For specialised or invasive treatments, your physician may have you sign a consent form and/or have you verbally agree to the proposed treatment options. Your physician will ensure you are informed of the risks, beneﬁts, cost, adverse effects and alternatives of the proposed treatment. You always have the right to refuse or withdraw consent to any treatment at any time. Your refusal of any specific procedure will not affect other care of future treatments.
Your signature at the bottom of this form indicates you have read and understood the following:
- I understand that Psy Integrated Health Inc. dba Empower Health Wellness Centre (“Psy Integrated Health”) expressly denies any liability associated with the provisioning of health services by our naturopathic interns and doctors to me. By signing this informed consent, I acknowledge and agree that Psy Integrated Health is not liable for any claim(s) arising from the relationship between myself and my naturopathic interns and doctors including any acts or omissions related to the services or treatment provided by such Practitioner, and that I will indemnify and save and hold harmless Psy Integrated Health against any such claims that I or my personal representatives may have in such regard.
- I understand that if my case requires specific examinations or diagnostic imaging not provided by the naturopathic interns and doctors, an appropriate referral will be made to another health professional.
- I will inform my naturopathic interns and/or doctor if I am pregnant, suspect I am pregnant or if I am breastfeeding.
- I will inform my naturopathic interns and/or doctor of any disease process that I am suffering from and any medications/over the counter drugs that I am currently taking.
- I understand that the naturopathic interns and doctors adheres to the Psy Integrated Health’s payment and cancellation policies.
- I understand there are no guarantees for treatment results.
- I confirm that all health conditions not being addressed by my naturopathic interns and/or doctor are stable and being monitored by my primary care physician or specialist.
I understand that some treatments carry the following risks and adverse effects:
- Allergic reactions from supplements, intravenous therapy, herbs, or allergy desensitization.
- Pain, bruising, or injury from blood tests, injections or acupuncture.
- Muscle strains, sprains, disc injuries, or stroke (rare) from spinal manipulation or other physical therapies.
- Aggravation of pre-existing symptoms from dietary, homeopathic remedies and detoxification protocols.
Naturopathic interns and doctors are required to maintain patient conﬁdentiality as per the bylaws of the College of Naturopathic Physicians of BC (CNPBC). Your personal information is collected for the purpose of providing health care and for administrative purposes. It will not be disclosed for other purposes without your consent other than for reasons stated in the bylaws of the CNPBC. A copy of these bylaws may be found at the CNPBC website (www.cnpbc.bc.ca) or we will print a copy of the relevant section for you at your request.
By signing below, I give my informed consent to Naturopathic Treatment from the naturopathic intern and doctor team.