Waiver and Consent for Services For Scope Chiropractic (‘Waiver’)
The purpose of this Waiver is to provide you with information, inform you of the risks associated with engaging in any Chiropractic care and exercise sessions (our ‘Services’) as well as your options to cease Services with Scope Chiropractic at any time.
Our Chiropractic sessions may involve various exercises and movements to test your ability to manage certain tasks. Our Services may also involve the use of various techniques, treatments and procedures that may involve movement of the joints where some ‘popping’ noises may be heard or felt. This is a normal result and will not have any long-term negative effects.
We also utilize soft tissue techniques including but not limited to massage, active release techniques and dry needling/acupuncture.This is a normal result and will not have any long-term negative effects.
Payments, Cancellation and Refunds
By providing Scope Chiropractic with your payment and credit card details, you authorise payment for our Services. In the event you have chosen payments to be made on a recurring basis, you hereby authorise such payments to be deducted by Scope Chiropractic for any programs, sessions or Services you have signed up for. This includes but is not limited to any fees for late cancellation or no-show in accordance with our Cancellation Policy. All payments and personal information will be kept in a secure manner in accordance with Australian privacy requirements.
In the event your Practitioner is required to cancel any session or appointment, we will either reschedule at a time convenient to you, the session will be transferred to another date or the fee will be refunded depending on the circumstances appropriate and available to both parties.
There are no refunds for Services that have been provided. Whilst we at all times abide by Australian Consumer Law in relation to our services and refunds, any other refund at any time is in our sole discretion.
Please note: there is a cancellation policy which requires 12 hr notice for any late cancelled or rescheduled sessions with a $50 fee charged for any cancellations or reschedules within 12 hrs of any scheduled session. This same fee will apply to any missed appointments. You will be charged for any cancellation on the credit card provided or via an emailed invoice.
Disclaimer for Risks Associated with Services
There are inherent risks associated with commencing any new service or treatments that may impact your health or well-being in any manner. You agree and confirm that it is your responsibility to consult with your doctor or medical professional before starting any new treatments, exercise programs, health regime or taking any course of action that may directly or indirectly affect or impact your health or well-being. If, at any time, you feel any discomfort or your health is affected by commencing our Services, please stop and let us know immediately.
The risks of spinal manipulative care are extremely low (1:400000) do include weakness in a limb, loss of bowel and bladder control or bone fracture. Other extremely rare conditions associated with the neck include stroke, paralysis or even death. Orthopaedic and neurological tests are performed to determine if you are in a high-risk category for any of these complications.
Dry needling (DN) is a skilled technique performed by a physical therapist using a single-use, single-insertion, sterile filiform needle, which is used to penetrate the skin or underlying tissue to effect change in body conditions, pain, movement, impairment and disability. Like any treatment there are possible complications. While these complications are rare in occurrence, they are real and must be considered prior to giving your consent for dry needling treatment.
You confirm and warrant that you have brought to our attention any and all medical, physical, injury or other health issues that may determine the suitability of chiropractic sessions and any exercise program we may recommend for you. In particular, it is your duty to notify your Practitioner of weak bones, diagnosis of any bone weakening disease such as osteoporosis, spinal disc conditions such as bulges or herniations, neck pains, or stroke.
You also understand that your participation in these sessions may involve a further risk of injury or may otherwise impact your health negatively. You take full responsibility and risk for making any decision, engaging our Services or taking any action based on our recommended exercises or during any session. You hereby agree to irrevocably release and waive any claims you may have now or in the future against us and we take no responsibility or liability whatsoever for any loss, damage or injury that may arise from any person acting on any information or undertaking our Services and all such liabilities are expressly disclaimed.
Discomfort and Results of Services
You may feel soreness, temporary increased pain or other symptoms following the first few sessions. These should go away but if they persist, you should inform your Practitioner.
In the case of spinal manipulation, some temporary localised tenderness at the site of the adjustment may be experienced or a change in the arms, trunk or legs may be felt. These conditions are temporary and may be noticed for up to 72 hours after the adjustment.
You may experience a mild to moderate level of discomfort after engaging and commencing our Services but this is normal as general exercise causes delayed muscle soreness. Alternatively
where you have recently suffered injury, it will take some time, energy and discomfort to teach and train your body to adapt, heal and get stronger. Please let us know immediately so we may discuss alternatives and understand the level of any discomfort as well as be able to advise if you need to seek attention or consult with your medical practitioner.
You need to let us know immediately if you do not feel comfortable performing any exercise we may suggest or if you feel moderate discomfort during any exercise or Session.
We will stop any Session to discuss your symptoms, discomfort and arrange for immediate medical assistance if necessary. You are not required to perform any exercise and any
participation in our Sessions is entirely voluntary. You may ask to stop at any time prior or during a Session.
Please let us know at any time before, during or after any Session if you have any questions about our Services. We, at all times, encourage your queries and feedback as it helps us to both improve our Services and ensure we are providing Services that meet your needs.
The aim of our Chiropractic sessions is always to improve a patient’s health, however, we do not guarantee any particular results. Progress differs from individual to individual and is highly dependant on your continuing ability and dedication to performing the program recommended and any exercises on a regular basis as advised.
You understand that your participation in these sessions and our Services may involve a risk of injury and you take full responsibility and risk for making any decision or taking any action based on our recommendations during our Sessions.
You hereby agree to irrevocably release and waive any claims you may have now or in the future against us and we take no responsibility or liability whatsoever for any loss, damage or injury that may arise from any person acting on any information, or our Services and all such liabilities are expressly disclaimed.
This Waiver continues forever and binds your heirs, successors, executors, personal representatives and assigns.