Consent Form Alternative

by | Forms & Lists

I understand and realize there may be risks and hazards in continuing my present condition without conventional medical treatment, but I am choosing to listen, understand and incorporate alternatives in eating habits, supplement programs or lifestyle changes that I feel will benefit my health and current condition. . . I also understand that it is not the intent of Dr. Denice Moffat to diagnose or prescribe. We are here to receive health information. In the event that I use this information without my doctor’s approval, I am prescribing for myself, which is my constitutional right.