I hereby authorise and give my consent to undergo acupuncture and other procedures falling within the domain of Oriental medicine, to be administered by Deepak Bhangu (Dip Ac TCM) or any medical professional associated with, employed by, or acting as a substitute for the aforementioned practitioner, regardless of their affiliation with the clinic or any other medical facility, regardless of their status as signatories to this document.
Treatment Risks
I acknowledge that there are inherent risks associated with the treatment, including but not limited to potential skin bruising and slight bleeding. In exceedingly rare instances, more severe risks such as nerve damage, paralysis, or even death may occur. It is important to recognise that this list is not exhaustive and other potential risks may also exist.
In the event that moxibustion or heat therapies are employed, it is essential to acknowledge the potential risk of burns and/or scarring. However, when all needles are appropriately sterile, the risk of infection remains minimal. Sterility is ensured either through disposable needles or autoclaving, adhering to applicable legal requirements.
I have been afforded the opportunity to engage in a discussion with the aforementioned practitioner regarding the fundamental nature and purpose of Oriental medicine (TCM).
Treatment Results
It is crucial to recognise that outcomes are not guaranteed. While the practitioner endeavours to provide a comprehensive explanation of potential risks and complications, it may not be feasible to anticipate and elucidate every possible scenario. Consequently, I place my trust in the practitioner’s professional judgment to act in my best interest, exercising sound discernment based on the information available during the course of the procedure.
I understand that I have the choice to accept or reject the proposed diagnostic procedure or treatment, or any part of it, before or during the diagnosis or treatment.
I acknowledge that the practitioner does not provide Western (allopathic) medical care, except when conducting orthopaedic acupuncture, mobility treatments, osteopathic, or chiropractic adjustments, which fall outside the scope of TCM. For Western medical services and routine check-ups, I should consult my primary care practitioner (i.e., GP).
Treatment Cancellations
To cancel a treatment session, I understand that it is essential to provide 24 hours’ notice. Failure to do so or non-attendance at the scheduled appointment will result in full payment within 24 hours of missed appointment.
Confirmation and Understanding
I confirm that I have thoroughly reviewed or had the contents of the above consent form explained to me. I have also had the opportunity to seek clarification on any questions I may have had. By signing below, I willingly consent to the specified procedures. This consent form is intended to encompass the entire course of treatment for my current condition and any future condition(s) for which I may seek treatment.
By signing this agreement, I release WLPT Limited trading as DeepakBhangu.com from all liability in connection with any injuries that may occur during the administration of treatments. I agree to hold WLPT Limited trading as DeepakBhangu.com entirely indemnified from any liability, including financial responsibility for injuries incurred, regardless of whether such injuries are a result of negligence.
I further acknowledge that I shall not hold WLPT Limited trading as DeepakBhangu.com or its staff accountable for any present or future injuries resulting directly or indirectly from any acupuncture or acupressure treatment or services that I have received or will receive from DeepakBhangu.com.
