Terms and Conditions

1.  Any potential risks and/or side effects for the assessment and recommended treatments.

2.  Whenever possible the same physiotherapist will attend to me. Treatment plans may change if the change in my condition requires.

3.  Relevant information relating to my medical condition and treatment (including the disclosure of ICD10 codes to classify my medical condition and treatment) may be provided to medical colleagues, administrative staff, the practices attorneys and debt collectors as well as medical aids.

4.  I am able to decline or withdraw from treatment any time with full comprehension of the consequences I believe that may cause harm to me.

5.  I understand that there will not be any refund of service charges for a session which is already initiated or completed. Please note  for the package validity in your invoice  since no extensions will be entertained .Refund will be provided for the sessions that are left out in a package session, if the client has not availed them with prior information passed on to the clinic, and only if the validity period of the package has not expired.

I understand and agree with the with the criteria above and as such agree to participate in an assessment and treatment for my present condition, commencing on the date that this form was filled. I understand that I may ask questions at any time, and that my consent may be withdrawn in writing at any time, except for actions already taken.