Consent Form

Homeopathy is a Complementary and Alternative Medicine System based on the natural law, “Similar Cures Similar”. It is an energy healing system which treats the whole patient with the totality of symptoms in general, mind, and physical spheres, giving importance to the peculiar and strange sensations; feelings; fears; modalities; and constitution of the individual patient. This system of medicine was founded by German medical doctor Samuel Hahnemann, MD, in the 18th century. 

I understand and provide my informed consent to Homeopathy Consultant Manisha Lakhekar / Homeocare HK Ltd. after having discussed to my complete satisfaction the status, benefits, and known/unknown risks of any assessment and treatment therapies provided. I am also fully aware that Homeopathy works on information that I provide about myself, feelings, emotions, constitution, ailments etc. and the effectiveness of the system depends on accuracy of the information provided by me.  Any incorrect or inaccurate information will result in wrong remedy selection and may not be effective and I am aware of the risks involved. I understand that I must visit hospital in case of any emergency. I am aware about the procedure, and it is carried out in my good faith and best interest and the following points have been explained to me:

(a) the benefit of the procedure; (b) the risk of the procedure; (c) the prevailing conventional method available

(d) the fact that this is a form of complementary/alternative treatment which is supportive.

I know that Manisha has not been trained in Allopathy & Western diagnosis or treatment and has not made any suggestions about altering/stopping my current medical care or treatment whether western or any other medicines or treatment that I am undergoing or wish to undergo in future.

I have read and understand the above disclosure about the alternative systems of health treatment and Manisha’s education and experience. I understand that Manisha is not licensed as a physician in Hong Kong and that the homeopathic treatment is a form of alternative and complementary medicine. I also understand that it is my responsibility to maintain my medical relationship with the primary doctor/family doctor/physician for myself/my child and inform him/her of the complementary homeopathic treatment taken and visit hospital in case of any emergency. I also give my consent to record my case which will be needed for further studies about my case.

I have carefully read and understand all of the above information and I choose to sign this document and give my permission to begin the homeopathic treatment.