Informed Consent / Terms & Conditions
Chiropractic care is one of the safest forms of health care available. However, health care practitioners are required to inform patients of any possible risk, no matter how rare or slight.
Some people/animals may experience some mild soreness for 24-48 hours after their adjustment. This is a normal sign of change, as may occur after exercise or stretching. For understanding exactly what to expect with your visits click here. And to find the answers to commonly asked questions click here.
Informed Consent
As with all health care providers, the law requires that practitioners obtain an informed consent that complies with the Code of Health and Disability Services Consumers’ Rights, particularly Rights 5, 6 and 7. This provides patients with a risk assessment of the care to be provided.
Chiropractic adjustments of the spine are internationally recognized as being safer in dealing with neck and low backpain than medication and other alternatives (A risk assessment of cervical manipulation, JMPT, 1995. Manga Report, Ontario Ministry of Health, 1993).
Some chiropractic treatments of the neck have been associated with damage to the vertebral artery giving rise to stroke, or stroke-like symptoms. This is extremely rare, occurring in approximately 1 in 5.85million (Haldeman, et al. Spine, 1999, Vol 24:8). Other rare complications reported include sprain/strain injuries, irritation of disc conditions, and fracture.
Whilst none of these complications have ever occurred in this practice, the practitioners at Heal Clinic provide a thorough analysis of your health history and physical examination to assess your overall health, and to ensure that you are not at risk.
The chiropractors at Heal Clinic provide a unique service that is modified for each individual. The appropriate referral to another health care provider will be supplied when indicated.
If you have any questions related to the care you about to receive, please speak to the chiropractor.
Please sign your New Patient Electronic form if you give permission to the chiropractor to examine and administer care as deemed necessary and to consent for clinical information to be communicated between your GP or other specialists/Chiropractic practitioners where appropriate.
CHILD/TEEN/STUDENT POLICY
All Initial Consultations (First Appointment) and Report of Findings (Second Appointment) for children under the age of 16, a parent or guardian over the age of 18 years old must attend these appointments.
We then still require a parent/guardian present at all regular appointments for children under the age of 13.
Once a care plan has been established, regular appointments can proceed without a parent/guardian present for children aged between 13 years and 16 years of age, provided we receive written/signed permission from a parent or guardian. For these appointments, treatment will provided with the door open and a Chiropractic Assistant available as a support person.
Privacy and Confidentiality
The information I have provided is true and correct.
I authorise the collection, storage, use and disclosure of my personal information in accordance with the privacy act 1993 and health information in accordance with the Health Information Privacy Code 1994.
Terms & Conditions
Payment for Services
I understand that payment for my, or my animals care is to be made before or on the day of each visit.
I also understand that should I have any outstanding invoices on my account including but not limited to declined ACC claims, administration charges, regular appointment fees, outstanding payment plan payments or missed appointment fees, that have not been paid fully within seven calendar days from the date of issue, Heal Clinic at their own discretion may choose to send my outstanding account to a collection company of their choosing and I will be required to pay any and all collection fees associated with my outstanding account at Heal Clinic.
Cancellation Policy
We have a 24 hours cancellation/rescheduling notice policy for our standard appointments and 48 hours on any appointments longer than 30 minutes (family appointments, new patient consultation, examination, new injury). If the required notice is not given I understand that I will be liable to pay 100% of the total appointment fee.
Waiver
We are allied health practitioners and are distinct from registered medical doctors. To the extent permitted by law, we will not be liable for damages of any kind (including without limitation any special, incidental or consequential damages) arising out of or in connection with any advice, treatment, other information or services provided by us to you with your consent.
I have read and fully understand the above statements. All questions regarding the objectives pertaining to my care in this practice have been answered to my complete satisfaction. By completing and submitting this form I therefore accept chiropractic care on this basis.