Please read, sign, and submit this online Homeopathic Treatment Consent Form at least 48 hours prior to your scheduled Initial Intake Appointment. Homeopathic Treatment Consent Form Evoke Homeopathy & Wellness Homeopathy is a holistic and individualized alternative healing modality that addresses symptoms of disease through homeopathic remedies that encourage the body to self-heal. I understand that I should remain under the care of an allopathic physician while receiving homeopathic treatment. I understand. I do not understand. Homeopathic remedies can be taken concurrently with allopathic medications. If I am taking prescribed allopathic medications, I will remain under the care of my physician and follow his/her recommendations for medication dosing. I understand that Astaire does not have the authority to recommend changes in medication dosing. I understand that, during the process of homeopathic treatment, as my symptoms improve, it might become necessary to adjust medication dosing and this can only be done through my prescribing physician. I understand. I do not understand. I give permission for Astaire Roorda to share details of my symptoms with colleagues and/or a supervisor for the purpose of seeking advice and input, should this become necessary. Yes, I give permission. No, I do not give permission. Signature * Clear Submit Should be Empty:
