Regarding Treatment and Care– I hereby request nutritional consultations and functional medicine treatment. I understand that in the practice of functional medicine, some treatments are considered “alternative” and ‘holistic’ by the conventional medical community.

Regarding Diet Recommendations and Nutritional /Herbal Supplements— The healthcare provider may make diet recommendations as well as recommendations regarding use of nutritional and herbal supplements, in order to supply nutrition to support the physiological and biomechanical processes of the human body. Although these foods and products may also be suggested with a specific therapeutic purpose in mind, their use is chiefly designed to support given aspects of metabolic function. Use of nutritional supplements may be safely recommended for patients already using pharmaceutical medications (drugs), with proper timing and dosage instructions. For this reason, it is important to keep all of your healthcare providers fully informed about all medications and nutritional supplements, herbs, or hormones you may be taking.

By signing this agreement, you are happy for me to consider your health as an individual, and where appropriate, especially with chronic illness, the healthcare practitioner will try to get to the root of your problems with targeted testing and treatment. You agree to have virtual nutritional consultations and Diagnostic nutrition testing, if required.

You agree that the healthcare provider, will send a report to or communicate with other health professionals relating to your care, this is especially important with chronic illness. You agree to provide your lab. Test results, relative to your problem, for your full assessment and in order to target the cause of any compromised system of the body.

Treatment recommendations will include a combination of medications, herbs and supplements. A consent from you will be much appreciated, before we proceed with these recommendations.