Patient Consent & Regulation

HEALTHWISE PATIENT CONSENT FORM POINTS

- I have been explained my medical condition and its prognosis, and the benefits and possibilities of my treatment/nutritional therapy along with the course of action clearly.

- The degree of benefit obtainable from nutritional therapy may vary between patients with similar health problems and following a similar nutritional therapy program. While the treatment and nutritional advice will be tailored to better the health conditions/concerns

identified and agreed upon, I understand that the results or outcome of the treatment and nutritional advice or the sustainability of the results cannot be guaranteed.

- I agree for my medical record to be accessed by your clinic staff involved in my / my family member’s clinical care.

- If a staff member is exposed to my blood sample, I consent to it being collected and tested for infectious diseases. I understand that I will be informed if the sample is tested and that I will be given the results of the tests.

- I consent to photography/videography to be taken during my consultation and treatment for the purpose of documentation, progress monitoring and for further medical research.

- I consent to regular follow-ups with the clinic staff for monitoring my progress and I will keep them aware of my latest health condition, developments, reactions and blood investigations.

- I understand and hereby acknowledge that any behavioral misconduct of any form, verbal or physical, to the staff or at the clinic, from my end, can lead to immediate termination of all treatments, without any refund. Behavioral misconduct includes harassment, bullying or intentional harm in person and or on social media. 

- As with any medical procedure or medical treatment, unforeseen complications could arise. I am aware of this fact and I acknowledge that if any such unforeseen complications arise, the clinic and its staff would neither be liable nor held responsible for it. The clinic staff will do its best to mitigate the effects of such unforeseen complications or may further re-direct me to other sources for advanced/alternate medical attention.

- I hereby acknowledge that the nutritional therapy program and medical treatment that I will undergo has a ‘No-refund’ policy.

- Disputes, if any, are subject to Mumbai jurisdiction.