CONSENT FORM TERMS & CONDITIONS

I understand that Dev Naraine is a specialist in Sports care injuries and a qualified osteopath registered with the General Osteopathic Council (GOsC).

I understand that any information or disclosures that I make between Dev Naraine and myself are strictly private and confidential and will not be discussed with a third party without my consent if it is deemed necessary.

As part of my treatment I give my consent for Dev Naraine to take a written case history and to conduct an osteopathic physical examination to enable him to formulate a diagnosis and treatment plan.

I understand that as part of the examination and treatment I may be required to undress down to my under ware for the duration of the treatment.

In the course of a treatment I give my consent for Dev Naraine to use various techniques to facilitate the treatment process on the understanding that these have been discussed previously.

Dev Naraine may offer additional advice and exercise prescription as part of a post treatment care programme of which compliance is optional.

I understand that for a short period after treatment I may experience some soreness or tenderness to the tissues that were treated.

Under 18s must be accompanied by a parent or guardian and a signed consent to treat form must be completed before the first appointment.

Late attendance of more than 20 minutes will be considered a missed appointment and treatment after this point may be declined at my discretion.

I understand that a missed appointment will have to be paid for in full unless 24 hours prior notification is given.

Signed (Client) - Date

Signed (Parent/Guardian) - Date

Practitioner - Date


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