Consent to Chiropractic, Physiotherapy, Massage Care & Exercise Physiology
- Back2Health encourages you to actively participate in determining the direction, type and outcomes of your care. To achieve this goal it is important that our team members and practitioners give you all the information that you will need in relation to your particular health needs and discuss with you recommended care, rehabilitation and any specific factors that could influence the success of your care.
- Manual adjustments of the spine are internationally recognised as being far safer in dealing with neck and lower back pain than medication and many other alternatives. (A Risk Assessment of Cervical Manipulation, JMPT, 1995. Manga Report, Ontario Ministry of Health, 1993).
- I understand and I am informed that, in the practice of Chiropractic, Physiotherapy & Massage, there are some very slight risks to care, including but not limited to muscle and joint soreness or strains, nausea and dizziness, fractures, disc injuries, an exacerbation or aggravation of my underlying condition and strokes or stroke like symptoms, (approx. 1 in 5.85 million. Halderman, et al Spine vol 24-8 1999).
- I do not expect the practitioner to be able to anticipate all potential risk and complications associated with the proposed care.
- I acknowledge that I am aware of the potential risks and complications. I appreciate that results are not guaranteed.
- I hereby acknowledge my consent to the performance of Chiropractic, Physiotherapy & Massage Care by practitioners of this practice or any other practitioner working at Back2Health.
- I have read the above and understand that I will have my opportunity to ask questions about its content. I intend this form to cover the entire course of my care and for any other future health concerns for which I seek care. I understand that I can withdraw my consent at any time.
Appointment Protocols
At Back2Health we provide you with a Treatment Care Plan to help you reach your health goals. We recommend scheduling your future appointments as per your Care Plan recommendations to ensure better outcomes and to guarantee your preferred appointments days/times.
Our expectations of you, our valued patient:
Once appointments are scheduled, you will be provided with an email and text of your appointments and 24 hours before your appointment, you will be sent a text message with your treatment date and time.
We require you to confirm your appointment by replying to this message with Yes to confirm or No to reschedule 24 hours in advance or call Reception directly to reschedule.
Please turn your mobile phone to silent when waiting for your appointment, we appreciate if you need to answer or make a call, to please step outside but ensure you are ready at your appointment time. Removal of all jewellery is requested prior to your appointment for ease of treatment and safety reasons and to save time during your consult.
We have a comprehensive website (http://back2health.com.au/) where you will find information about all of our services, our online store, our blog and information about our practitioners. Please like us on Facebook (Back2Health) to keep up to date with special offers, workshops, products and service updates.
Cancellation Policy
24 hours notice is requested when cancelling or rescheduling appointments
Late cancellations and missed appointments are an inconvenience to other clients that may have wanted your appointment time, and to our team who frequently must turn clients away who require our services. Cancelling an appointment, you can no longer keep is highly appreciated by our team. We enforce the following late cancellation and missed appointment policy:
Missed/No Show appointments will be handled as follows:
1st Missed Appointment – As a courtesy you will not be charged
2nd Missed Appointment - $30 missed appointment fee will apply
3rd Missed Appointment – A full appointment fee will apply
Late cancellations within 24 hours will incur the same fees unless we are able to fill your appointment time.
We appreciate your time taken to read this information, please ask reception if you require any further details or explanation.
We thank you again for choosing Back2Health for your health and wellness needs.
Please sign below to show you understand and are happy to abide by the following policies you have read throughout this contract.
Written Consent for Dry Needling
What is dry needling?
This form of treatment uses very fine sterilised needles inserted into specific points in the body to reduce pain and muscle tension.
Is it safe?
Dry needling is a very safe form of treatment (1). Serious side effects are rare with an incidence of 0.02 per 10,000 treatment (2).
Are there any side effects?
Drowsiness may occur after treatment in some patients. If affected, you are advised to notify your practitioner and not to drive until the symptoms have resolved.
Minor bleeding / bruising occurs after dry needling in about 3% of treatments (1).
In a small percentage of patients, symptoms can become worse before improving. This is generally a sign that healing has begun. If the worsening of symptoms is concerning you or lasts for more than 2 days, contact your practitioner.
Fainting is rare, but can occur, particularly in new patients. To reduce the risk, it is recommended that you consume food within 2-3 hours prior to treatment.
Local infections can occur of bacteria on the skin are introduced into a joint by the needle. This is very rare – 0.014% per treatment (3).
The risk of Pneumothorax (collapsed lung) is extremely unlikely (less than 1 in 70,000 – 1.3 million) with appropriate technique (4). Precautions will always be taken to avoid any complications. Should you experience any shortness of breath in 24-hour period after treatment, please seek medical advice.
To minimise complications, we only use high quality needles, single-use, sterile, disposable needles that have TGA (Therapeutic Goods Administration) approval.
If you have any adverse reaction to the treatment, please notify your practitioner immediately.
I acknowledge that I am aware of the potential risks and complications. I appreciate that results are not guaranteed.
I hereby acknowledge my consent to the performance of Dry Needling care by practitioners of this practice or any other practitioners working at Back2Health.