Consent to handle Personal Information

Processing of your personal information - Consent.

To our valued patients,

Thank you for booking ab appointment with us.

We need your consent to hold your personal data for insurance, invoicing and patient notes.

We also need to let you know that physiotherapy involves many different types of physical evaluation and treatment.   As with all forms of medical treatment, there are benefits and risks involved.  All assessment and treatment will be explained to you before it occurs and consent may be removed at any time.

The physical response to treatment varies and cannot always be predicted as every individual is different.  There is no guarantee that the treatment will help the condition you are seeking treatment for and there is a risk that treatment will cause some discomfort or aggravation of the existing condition.

During your physiotherapy visit, in order to achieve the best possible result, it often necessary to expose and touch the area in need of treatment, however alternative methods can always be used.  At times, the practitioners may ask you to remove some items of clothing in order to facilitate treatment.  If you do not feel comfortable with any part of the treatment, please tell us immediately.  Every effort is made to preserve modesty and keep you comfortable.

There are many different treatment methods, one that may be used is acupuncture.  The Intended benefits of treatment include:

• Reduction of pain

• Alleviation of muscle spasm and tension

• Facilitation of the healing process

Possible adverse effects include:

• Bleeding and Bruising (3%)

• Mild aggravation of symptoms (3%, of which 70-85% show subsequent improvement)

• Mild Pain at the needle site (1%)

• Drowsiness (1%)

• Dizziness (0.6%)

• Pain not at needle site (0.5%)

• Nausea (0.3%)

• Feeling faint (0.3%)

• Stuck or bent needle (0.1%)

• Headache (0.1%)

• Allergy or infection (up to 0.2%)

• Pneumothorax (0.0002%/ less than 2 per 1 million).

Your physiotherapist will discuss these with you and explain if you are at any enhanced risk.

Another treatment is cupping which is a therapy that applies negative pressure on the skin using a plastic cups.  The suction created by these cups stimulates and increases blood flow, which can help relieve joint and muscle pain, reduce inflammation, accelerate recovery and increase the function of the lymphatic and circulatory systems.  Please be aware that this can leave temporary red marks or bruises.

I acknowledge the above and consent to a physiotherapy evaluation, discussion of diagnosis and any treatment as deemed appropriate by the treating therapist.

I am aware I have the right to decline treatment at any time.

Please read the below and click the link below to confirm your agreement.

Best wishes,

The KS Physio team