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The patient/parent/guardian herby acknowledges that health information is required to be collected by THE A LIFE in order to provide effective and appropriate treatment to the patient. The patient consents to and authorises the collection of such information by the practice and agrees that the patients medical records may be retained by the practice for the purpose of future treatment. The patient also consents to the information collected being shared between treating practitioners at the practice, and their GP where necessary, to provide the patient with appropriate and safe treatment.
CONSENT TO OSTEOPATHIC TREATMENT
Osteopathy care is recognised as being effective and safe method of care for many conditions. However, you must recognise that there are risks associated with all health care procedures, which you should be informed about. Please read the following carefully;
I understand that there are risks associated with Osteopathic treatment and the techniques used. These can include but are not limited to temporary soreness after treatment, bruising, muscle injury and/or exacerbation and/or aggravation of my underlying condition. Manipulation of the spine does carry risks which can include; injury to the the arteries of the neck (reported incidence 1:400000-1:2000000) which can cause stroke, rupture of discs causing arm or leg pain, weakness, pins and needles or numbness.
I understand that I will inform my treating Osteopath if I am suffering from any of the following that may increase the risks associated with cervical spine manipulation, especially if associated with movements of the head and neck.
dizziness, vertigo, fainting, visual disturbances, altered sensations in the face, nausea or vomiting, difficulty speaking or swallowing. Please ask your Osteopath about the above if you have any questions.
CONSENT TO DRY NEEDLING
Dry needling is a valuable adjunct treatment for chronic pain, stiffness, and to deactivate myofascial trigger points. Like any medical procedure, there are possible complications. While these complications are uncommon, they do sometimes occur and must be considered prior to giving consent to the procedure.
With the dry needling technique, a fine, flexible and sterile needle is used. The purpose of the needling is to release shortened bands of muscle caused by abnormal functioning of the nervous system. No drugs are injected.
Dry needling may cause an increase in pain for one to three days followed by an expected improvement in the overall pain state. The increased pain is related to overactive shortened muscle bands that have not been released and to the soreness caused by the “twitching” of the muscles.
Any time a needle is used there is a risk of infection. However, we are using new, disposable and sterile needles, and infections are extremely rare. A needle may be placed inadvertently in an artery or vein. If an artery or vein is punctured with the needle, a hematoma (or bruise) will develop. If a nerve is touched, it may cause paresthesia (a prickling sensation) which is usually brief, but it may continue for a couple of days. When a needle is placed close to the chest wall, there is a rare possibility of a pneumothorax (air in the chest cavity).
Fortunately, all these complications are not fatal and are readily reversible. Care will always be taken to respect your privacy; appropriate towelling will be used at all times.
CONSENT TO NATUROPATHIC TREATMENT
Whilst naturopathic practitioners undertake their utmost duty of care in the guidance and management of all clients’ presenting health concerns, consent to participate in treatment is entirely my own choice and I am responsible for my health outcomes.
You may cancel or reschedule up to 24 hours prior to your appointment. After this period we charge a fee of $35.
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