Additional Consent

CONSENT TO PHYSIOTHERAPY TREATMENT

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CONSENT FOR PHYSIOTHERAPY TREATMENT

The Undersigned, understand and declare that:

  • During the treatment and evaluation the physiotherapist might need to uncover specific body parts and the physiotherapist understands, that I may refuse to do so, if and when I do feel uncomfortable in doing so.
  • The physiotherapist will need to touch me, in order to provide effective treatment and that I will inform the physiotherapist if and when I feel uncomfortable in doing so.
  • It is my right to withdraw this consent at anytime or for any specific procedure or modality.
  • I have been informed of all benefits and risks of the procedures and or modalities. I have also  been informed of alternative procedures and modalities.
  • I understand the procedures and possible and possible potential complications and I had the opportunity to discuss this with the physiotherapist
  • I hereby consent to physiotherapy procedures and modalities that will be performed on me or my dependant: subjected to the physiotherapist performing the relevant safety testes and evaluation, and taking relevant precautions.
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