Please read, sign, and submit at least 24 hours prior to your scheduled Initial Intake Appointment. Client Rights & Responsibilities Evoke Homeopathy & Wellness Clients have the right to: privacy and confidentiality of all communication and records, except for life threatening situations, conditions of suspected abuse, or where the client has granted written permission receive the highest standards of care and conduct be treated with respect, dignity, and freedom from prejudice accurate information concerning remedy and dosing recommendations accurate information regarding the scope and availability of services accurate information regarding fees and charges related to appointments and remedies Clients have a responsibility to: provide complete information about one’s illness/symptoms, to enable proper evaluation and treatment ask questions to ensure an understanding of the treatment process pay fees in a timely manner remain under the care of the prescribing physician for any allopathic medications being taken during homeopathic treatment inform the practitioner(s) if one’s condition worsens or an unexpected reaction occurs from a remedy attend practitioner’s recommended follow-up appointment schedule, and respond to communication I have read and understand my rights and responsibilities. Signature * Please sign here using your computer mouse (or finger for touchscreen computers). Clear Submit Should be Empty:
