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Informed Consent for Online Consultations
By signing this form you acknowledge that you have read and agree to the following consent for online consultations and or treatment. You also agree to receive online or phone consultations by a physician working with or for North County Integrative Acupuncture Center, from here on known as NCIAC.
All online consultations are provided by a qualified health care practitioner licensed by the State of California. Consults are not guaranteed to cure, treat or diagnose health care complaints or diseases.
With your online consultation, your physician will recommend certain medical treatments, modalities, herbs, vitamins, supplements, and dietary and lifestyle adjustments. It will be up to you to be compliant with these recommendations.
You agree not to hold NCIAC or any of its affiliates responsible for any treatment, recommendation, or lack of desired results.
If taking herbs and supplements you agree to not hold NCIAC or any of its affiliates responsible for any negative side effects that may occur. You physician will speak with you about possible side effects if any, and explain how to take your supplements and or herbs appropriately.
Along with any recommendations made by NCIAC or its affiliates, it is very important that you also obtain consult from you primary care physician or specialist.
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