Client Declaration & Consent Forms

Before your first appointment we ask every client to complete a short health questionnaire and consent form. It helps us make sure your treatment is safe, appropriate and tailored to you.

What the declaration says

The full text of the client declaration and informed consent, as it appears in the New Client Health Questionnaire & Consent Form:

• I confirm that the health and personal information I have provided is accurate and complete to the best of my knowledge. I agree to inform the practitioner of relevant changes before future appointments.
• I understand that The Ayur Chikitsa provides complementary wellbeing services based on traditional Ayurvedic principles, and does not provide medical diagnosis, medical treatment or emergency care.
• I understand that Ayurvedic consultations, massage therapies, lifestyle guidance, meditation, Reiki and related wellbeing practices do not replace advice or treatment from my GP, consultant, pharmacist, mental-health professional or another regulated healthcare professional.
• I will not stop or change prescribed medication without consulting the qualified healthcare professional responsible for my care.
• I have disclosed relevant medical conditions, medication, allergies, sensitivities, pregnancy, recent surgery and injuries.
• I understand that the practitioner may modify, postpone or decline a service where there is a reasonable safety concern, or where the requested service falls outside their professional scope.
• I understand that I may ask questions, request adjustments, decline any part of a treatment, or withdraw my consent at any time.
• I consent to receiving the consultation or therapy agreed with the practitioner.

Explicit consent to process health information

This is a separate, explicit consent. It is never pre-ticked, and it is asked for on its own — separately from your consent to receive a treatment: