confidential
HEALTH QUESTIONNAIRE
Thank you so much for taking the time and trouble to complete this questionnaire. This will greatly help me to help you achieve your healthcare goals.
I very much look forward to seeing you at your appointment.
PLEASE NOTE: The information you provide on this medical assessment form is confidential and will not be discussed or shared with any third party unless absolutely necessary (e.g. GP) without your express consent.
If you have any questions at all, please do feel free to contact me via email at sarah@alchemilla.co. I’m happy to help.
Please do remember that I am herbalist and a naturopath, but I am not a doctor. I can’t prescribe allopathic medicines or make any diagnosis, but am happy to work with your GP for the benefit of your health.
Although everything possible is done to ensure a positive outcome, like everything in life, there is no guarantee you will always achieve 100% success. Each patient responds differently to care. Your progress is based on many factors, including your commitment to making lifestyle changes, compliance with suggestions, and adherence to the treatment plan.
By commencing treatment, you agree that I am not responsible for the success or failure of your treatment outcome.
T’s & C’s

HEALTH DISCLAIMER

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