Important Information for New Patients

Your initial consultation will take about 2 hours. During this meeting, your practitioner will gather many different kinds of information. Though this will be quite thorough, it is helpful for your practitioner to have your health history form in advance of your session. Please fill that out online using your assigned patient number.

Follow-up appointments are an important part of the homeopathic process. New patients should plan to be in for a follow-up appointment within 4-6 weeks after the initial consultation, and also plan for two more follow-ups (about 4-6 weeks apart or as recommended by the practitioner, dependent on your individual case) thereafter. Deep healing is a dynamic process, and your customized homeopathic treatment plan may involve a bit of tweaking at the outset. For this reason, it is important for your practitioner to help assess how things are developing over time.

General Consent Form For Homeopathic Treatment

Homeopathy and other holistic methodologies view health and illness from a different perspective than the standard, conventional medical approach, which limits its concerns to individual symptoms. The homeopathic interview takes the whole person into consideration, and regards the spiritual, mental, and emotional symptoms as important as the physical aspects.

Please continue reading below!

I am over 18 years of age and have voluntarily chosen homeopathic treatment for myself / my child. I understand that Nancy Frederick is a homeopath and not a medical doctor, and does not diagnose, treat or prescribe for any particular symptom, disease, or condition. It is therefore recommended that I retain the services of a primary care physician for appropriate evaluations and check-ups.

I understand that the goal of homeopathy is to increase my / my child’s general vitality and constitutional strength. Under no circumstances should any suggestions be taken as a medical diagnosis or direction against a licensed medical or mental health care professional.

I understand that all information disclosed to the practitioner during the homeopathic consultation is confidential and may not be revealed to anyone without written permission, except where disclosure is required by law.

I understand that a minor aggravation or worsening of some symptoms may occur temporarily as part of the healing process.

I authorize discussion of my case notes with other professional homeopaths if my (or my child’s) best interests be served by such a consultation. My right to privacy will be protected by withholding my name and any other identifying information.

Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Birth Time (if known)

Birth Place

City, State, Country

Email

Phone

(###)

###

####

Parents' Names (if under 18)

First Name

Last Name

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Signature: By typing my name here, I testify that I have read and understood the above.

Today's Date

MM

DD

YYYY

Referred by:

Information about Homeopathic Remedies

The remedy should be kept out of direct sunlight and away from sources of heat, electricity, and radiation. A homeopathic remedy is prepared from natural substances which have been highly diluted and refined. Its action can be extremely subtle, and is subject to interference from various outside influences.

A remedy dose should be taken at least 15 minutes before or after eating. You may be instructed to take a single dose, two or three doses relatively close together, or to repeat daily for several days in succession, depending on the nature of your condition and the strength of the dose.

To be avoided during the course of treatment

You may be asked to avoid (exposure to) certain substances during the course of treatment. Some essential oils, herbs, medications and stimulants may interfere with the action of a homeopathic remedy. Your practitioner will advise you in this regard at your initial consultation.

Dental procedures should be postponed until after the remedy has acted or failed to act, so that results can be clearly evaluated. Other therapies such as acupuncture and a chiropractor should not be started at the same time for the same reason. An occasional aspirin or Tylenol should be no problem.

Please make note of any changes, dreams, or symptoms to assist in understanding your response to the remedy. The effects may be so subtle or gradual that a friend or relative may point out changes before you notice them.

A simple, healthy routine which includes rest, exercise, meditation, laughter, and good food assists your body in healing itself. Lifestyle changes are not necessary. Try to avoid influences which have caused problems for you in the past.

Some people feel briefly euphoric, energetic or relaxed after taking remedies. Others may experience a return of symptoms from past illnesses, which will fade after a short time.

Feel free to be in touch at any time with questions or concerns.