Informed Consent for Naturopathic care

I would like to take this opportunity to welcome you to the services of George Cho, Naturopathic Doctor at Pathways to Wholeness Lifestyle Medicine Centres (North York, the Junction, Paradise Fields, and Scarborough). This practice utilizes the principles of Naturopathic, Nutrition and Lifestyle Medicine to assist the body's own ability to heal and thrive.

Dr Cho also works alongside various Certified Holistic Nutritionists (Riza Raspado CHN) who support the patients through Nutritional counseling. This consent form encompasses their services as well.


A number of different approaches may be used:

  • Clinical nutrition and Nutritional supplements

  • Nutritional counselling

  • Botanical/Herbal Medicine

  • Physical Medicine

  • Lifestyle medicine (including but not limited to sleep, exercise, stress management, and spirituality)

  • Hydrotherapy.


The slight health risks of some Naturopathic treatments include, but are not limited to: aggravation of pre-existing symptoms or conditions, allergic reaction to supplements or herbs and pain.


Your practitioner will conduct a thorough case history. As part of a naturopathic / nutritional intake assessment, a physical exam and/or specific laboratory tests (blood and/or urinary) may be required and used as part of the treatment work-up (as deemed necessary after a comprehensive intake). Although Naturopathic Medicine, lifestyle medicine and nutritional therapies use very gentle therapies, even these may induce complications in certain physiological conditions such as pregnancy, lactation, very young children, very elderly and in certain conditions including but not limited to diabetes, liver, heart or kidney disease. It is therefore important to inform your Naturopathic Doctor of any illnesses you suffer from or medications you may be taking (prescription or over-the- counter).If you are a female and are pregnant, suspect you may be pregnant or are nursing, please advise your Naturopathic Doctor immediately.


Tele-medicine services

There may be certain instances where both patient and the Naturopathic doctor / Nutritionist may deem it most appropriate to do consults by telephone or using conferencing software. Telemedicine is the use of electronic information and communication technologies by a healthcare provider to deliver services to a patient when he/she is located at a different site than the provider.

I understand that the laws that protect privacy and confidentiality of medical information also apply to telemedicine. As always, your insurance carrier will have access to your medical records for quality review/audit. 


I also understand that during a telemedicine consult:

  • there are limitations to the level of physical examination that the Naturopathic Doctor or Nutritionist can perform.

  • I may revoke my consent orally or in writing at any time by contacting Dr George Cho Naturopathic doctor at 647-548-6480 or info@pathwaystowholeness.ca



Agreement

As a patient of Dr George Cho ND and or Certified Holistic Nutritionist Riza Raspado CHN:

  • I am at liberty to seek or continue medical care from a medical doctor or other health care provider.

  • This consent form is intended to cover the entire course of treatment for my present condition.

  • I understand that I am free to withdraw my consent and to discontinue participation in these procedures at any time.

  • I understand that a record will be kept of the health services provided to me. This record will be kept confidential and will not be released to others without my consent, unless required by law.

  • I understand that I may look at my medical record at any time and may request a copy of it by paying the appropriate fee.

  • I understand that the Naturopathic Doctor will answer any questions I have to the best of his ability. 

  • I understand that the results are not guaranteed.



With this knowledge I voluntarily agree to the diagnostic and therapeutic treatments above. 


I understand that treatment advice will not be given over the phone or via e-mail unless directly relating to specifics discussed during a clinic visit.


I accept full responsibility for any fees incurred during care and treatment. I understand that charges are to be paid at the time of the visit unless previous arrangements have been made prior to my scheduled appointment.

I also understand that the Cancellation policy requires me to cancel and/or reschedule a booked appointment 24 hours prior to a given, scheduled appointment. Cancellations with less than 24 hours notice will incur a charge of 100% of the scheduled office visit fee that must be paid prior to the next visit.