• Fountain Health Wells

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  • Consent Form

  • Osteopathic treatment, like all forms of health care, while offering considerable benefits, may also provide some level of risk. Research has identified Osteopathic treatment as one of the safest forms of treatment. We require every patient to make an informed decision about begining Osteopathic treatment. 

    Prior to receiving Osteopathic treatment at Fountain Health Wells, a health history will be established and a physical examination will be completed. These procedures are performed to assess your specific condition, determining if Osteopathic treatment is needed and can help. 

    During your Osteopathic treatment, it is often necessary to expose and palpate certain areas of the body for diagnosis and treatment. Every effort is made to preserve modesty and keep you comfortable. Please communicate with the Osteopath if you have any concerns during treatment and if you ever feel uncomfortable please do not hesitate to say. 

    Before any manipulation is given, the Osteopath will obtain verbal consent and the patient has the option to opt out at any time. 

    The physical response to treatment varies and cannot always be predicted, as every individual is different. Whilst rare, some patients may experience short-term aggravation of symptoms of achiness on the day of treatment and even the day after. It is important to follow the advise of the Osteopath to reduce any chance of adverse effects from treatment. This may include using hot/ cold treatment, resting, refraining from certain activities. 

  • Statement of Consent for Adult Patients

    I consent to receive Osteopathic treatment but I understand I can refuse treatment (or any part of treatment) now or in the future without jeopardising future treatment at this practice. 

    I understand that it is important that I inform my Osteopath of any concerns, reactions or discomfort associated with treatment. 

  • Statement of Consent for Aged 16 Years or Younger

    I consent, as parent, guardian or appointed carer to this patient receiving osteopathic treatment at this time. I understand that they can refuse treatment (or any part of treatment) now or at any time in the future without jeopardising future treatment at this practice. 

  • General Data Protection Regulation (GDPR) 

    At Fountain Health Wells we take your privacy seriously. Please confirm you consent to us obtaining, processing and storing your medical information by signing below. Please note we will not share your personal information with anyone without your consent. 

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