Disclosure & Consent

I understand that methods of treatment used in this practice may include, but are

not limited to, herbal medicine, nutritional medicine, energetic medicine, lifestyle and dietary modifications, prescriptions, physical examinations such as, blood pressure recording, palpation of abdomen, auscultation of heart and or lungs, visual examination of iris, nails and skin, general patient counselling and referral for pathological testing.

I understand that Naturopathy is considered a safe method of treatment, however potential risks include contraindicated effects of medicine prescribed when full disclosure of other medicine used are not given, reaction or adverse effect of a supplement or herbal medicine.

risks are allergic reaction where not previously specified or adverse effects of a medicine.

I fully understand that there is no implied or stated guarantee of success or effectiveness of a specific treatment or series of treatments. I also understand that certain social habits and medications may decrease the beneficial effects of Naturopathic treatment. These include the use and abuse of alcohol, pain killers, steroids, narcotics, tobacco, anti-depressants, and illegal drugs.

Naturopathy is a natural medicine that works with the body’s ability to heal itself, but is not a substitute for conventional medical diagnosis and treatment. The results of Naturopathy are not always felt immediately, especially with chronic conditions. Frequent, regular treatment is what gives Naturopathy and herbs the best results.

I will notify the Naturopath, should I become pregnant or if I am in the process of trying to get pregnant so that my practitioner can avoid medicines that could induce miscarriage.

Otherwise, naturopathy treatment can be very beneficial in the pregnancy and birthing process.

I understand that herbal and nutritional supplements recommended to me by my Naturopath are safe in the recommended doses. Large doses of herbs or supplements taken without my practitioner's recommendation may be toxic, and some herbs are inappropriate during pregnancy.

Some possible side effects of herbs and supplements are nausea, gas, stomach ache, vomiting, headache, diarrhea, rashes, hives and tingling of the tongue. I understand that I must stop taking any herbs and notify my naturopath as soon as I experience any discomfort or adverse reactions.

I understand that I can discuss risks and benefits further with my practitioner before signing if I so choose. However, I do not expect my practitioner to be able to anticipate and explain all possible risks and complications of treatment. I rely on the practitioner to exercise his or her judgment in my best interest during the course of treatment, based upon the facts then known.

In signing this form, I acknowledge any inherent risks, and give my consent for treatment, payment and healthcare operations received, incurred or carried out at this practice.

I also certify that I have informed my naturopath of all known physical, mental and medical conditions and medications, and I will keep her updated on any changes.

I agree that any use of online products, programs or webinars purchased have a no-refund policy and communication with Mellisa Walker is to be made within 24Hrs of purchase if you are unhappy with your service, so a desirable outcome for both parties may be discussed.  

I agree that the use of content such as yoga, meditation, self care and any other education information is done so at my own risk and Mellisa Walker Naturopath can not be held responsible for any illness, damage or death resulted by my individual action. 

I understand Mellisa Walker Naturopath does not and will not diagnose, claim to cure any health condition & that she will only work in her scope of practice as a qualified naturopath, childbirth educator and breastfeeding counselor.