TERMS AND CONDITIONS AND INFORMED CONSENT TO OSTEOPATHIC TREATMENT

When performed by a qualified osteopath, osteopathic manipulation of the spine, joints, muscles and other parts of the musculoskeletal system have a low incidence of serious injury (permanent, disabling or life-threatening). There are risks associated with any treatment and we are required to inform you of these.  In very rare circumstances, neck HVLA, or “cracking”, may damage blood vessels and cause a stroke or stroke-like episodes (It is believed the risk is estimated to be 1-2 per 50,000-250,000,000 manipulations performed).

Please read the following carefully and discuss any questions you may have with your treating practitioner.

In the course of managing your musculoskeletal care myOsteo collects personal health information necessary to understand your health, function, capacity, etc and it is held on a secure electronic practice filing system. You can at any time request a copy of any personal health information collected and included in your record from your consultations with us as for seven years.  A copy of the clinic’s Privacy Policy is available on request.

I request and consent to the performance of osteopathic manipulation and other osteopathic procedures.

I confirm that I have had the opportunity to discuss with the osteopath named below the nature and purpose of osteopathic manipulation and other osteopathic procedures. I understand that results are not guaranteed.

I understand, and acknowledge that I have been informed that, in the practice of osteopathy, as in the practice of medicine, there are some very slight risks to treatment including, but not limited to, muscle and joint soreness, muscle strains, joint sprains, fractures, disc injuries and strokes. I do not expect the osteopath named below to be able to anticipate and explain all the risks and possible complications to me. I wish to rely on the osteopath treating me to exercise his or her judgment during the course of my treatment in such a manner and to the extent that he or she feels at the time, based on the facts then known, is in my best interests.

I have read the above and confirm that I have also had the opportunity to ask questions about its content. I intend this consent form to cover the entire course of treatment for my present condition, and for any other future condition(s) for which I seek treatment. I understand that I can withdraw my consent at any time verbally or in writing.

This clinic has a 24-hour cancellation policy that applies to all appointments. Failure to provide 24 hours’ notice when changing or cancelling appointment times and missed appointments will result in a cancellation fee to cover cost. It is expected that you will pay for each appointment at the end of your session.