Please read the full agreement carefully, then sign below.
Elham Ansari Ayurveda and Natural Medicine would like to take this opportunity to welcome you!
We utilize the principles of traditional and natural medicine to aid in the treatment and prevention of illness, as well as maintain overall health. We will conduct a detailed case history and clinical assessment of your conditions, constitution, diet and lifestyle. A detailed protocol of recommendations will be created specifically for you. Recommendations may include diet, lifestyle, movement, breath, supplements, herbs, mindset, energy medicine, etc. Please read and sign below to agree to our terms and conditions.
- 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 unless required by law. This privacy policy is in compliance with bylaws.
- I understand that I am receiving supplementary health recommendations and not medical advice. Any information obtained, verbal or text and other material are for informational and educational purposes only. Recommendations are not intended to be a substitute for professional medical advice, diagnosis or treatment.
- I agree to always seek the advice of my primary health care provider, physician or other qualified health care provider with any questions regarding a medical condition or treatment and before undertaking a new health care regimen. I agree to not disregard professional medical advice or delay in seeking it because of something recommended.
- I understand that any advice given to me as a client is not mutually exclusive from any treatment or advice I may now, or in the future, be receiving from another health care provider.
- I understand that I am at liberty to seek, or to continue medical care with, another qualified health care provider.
- I recognize the potential risk of some treatments that include but are not limited to: aggravation of pre-existing symptoms, allergic reactions to supplements, herbs or other natural or alternative therapies.
- I understand that the services offered here are not covered by MSP, and that fees are payable at the time of appointment.
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I understand fees for services from Elham Ansari Consulting are as follows and are payable at the time of the appointment.
Health Coaching Package Includes:
- 4 sessions (over a two month period)
- Written recommendations and health plan
- Comprehensive guidance including email and phone support
Cost: 770+ GST (payment plan available)
Single Session Rate Includes:
- Initial session (1.5 hrs)
- Written recommendations and initial health plan
Cost: 195 + GST
- I understand that 2 full business days notice is required for appointment cancellation or re-scheduling (via telephone or by email) or I will be responsible for the full cost of the missed appointment.
