The following is for all new patients at Elements Osteopathy and to be filled out after making their first appointment.

 

General Consent to Osteopathic Care.

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Osteopathic care is recognised as being an effective and safe method of care for many conditions. However, you must recognise that there are risks with all heath care procedures, which should be informed about. All practitioners who use Osteopathic Manipulative Treatments on a patient are required to warn the patient of the possible risks associated with those procedures. In very rare circumstances, some treatments of the neck may damage blood vessels and even give rise to stroke like symptoms. (It is believed the risk may be approx. 1-2 strokes per 1,000,000 neck manipulations performed).

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Please read the following carefully;

1. It has been explained to me that there are inherent risks in any treatment plan or procedure. I acknowledge that I have discussed with my Osteopath the rare risks associated with my treatment which include but are not limited to muscle and joint soreness or strains, nausea, dizziness, fractures, disc injuries, strokes (or like episodes), dislocation, bleeding, bruising, inflammation and an exacerbation or aggravation of my underlying condition.

2. I have had the opportunity to discuss the proposed care with my osteopath and I have disclosed all the relevant health information needed. I also acknowledge that I had the opportunity to ask questions about the nature, extent and purpose of the proposed care and other alternative treatments and have been given sufficient time to make a decision giving consent for the care to proceed.

3. I acknowledge that I am aware of and understand the potential risks. I appreciate that a result cannot be guaranteed.

4. I do not expect my Osteopath to be able to anticipate every potential risk and complication associated with the proposed treatments plan and procedures.

5. I hereby acknowledge my consent to the performance of the proposed Osteopathic care by the Osteopath I have visited. I understand that I can withdraw my consent at any time in writing and that this consent form does not encompass the entire discussion I have had with the treating Osteopath regarding any proposed treatments.

6. By ticking the T&C box I hereby give my consent that I can withdraw at any time in writing

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Cancellation Policy

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Our cancellation policy states that “late cancellations” and “no show” appointments will result in and admin fee that is as follows:

• Over 24 hours before the appointment notice carries no fee

• Within 24 hours a flat $60 fee will be applied to the patient 

 

Failure to notify Elements Osteopathy (call 0466 016 026 or email drdan@elementsosteo.com) within these time frames either via phone or email will result in this admin fee being applied.

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The cancellation policy is enforced in consideration of patients on the waiting list. When insufficient notice is given, this puts great limitation on the ability to then fill the appointment time and will affect both waiting patients and the practitioner for their lost time.

 

Thank you for your consideration.