Retainer Agreement for Homeopathic Practice
, hereby retains Ron Frank, D.H.M. as a homeopathic practitioner.
I understand that Ron and associates do not seek to diagnose, treat, or prescribe for illness, injury, disease, disorder or other pathological conditions. Instead, he seeks to stimulate my own defense system with the use of homeopathic remedies and adjunct therapies, so that I can better deal with the wide variety of stresses I experience. In exploring this homeopathic practice, I am interested in monitoring my confrontation with stress and in stimulating my own healing abilities to move through crisis naturally.
I have had ample opportunity to discuss the relationship between the treatment of pathology and the employment of this homeopathic approach as practiced by Ron Frank, D.H.M. and his associates and assistants. I agree to consult a physician for any concern about pathology which may arise during the term of this agreement, and to inform Ron Frank, D.H.M. of such consultation and its results.
In choosing this approach, I realize that some of my symptoms of discomfort may get worse before they get better, and I could elect to minimize or eliminate uncomfortable symptoms by obtaining treatment, according to accepted standards of medical practice, from a physician. I am responsible for my health and any contraindicated medications, remedies, or lifestyle changes I will make myself aware of from an accepted standard medical physician.
In order to maximize the benefit which I might receive from this work, I agree to:
Practitioner, Ron Frank, D.H.M. agrees to elicit a history of indications relevant to the client’s constitutional disposition, advise the client accordingly, and provide the client with an opportunity to undertake homeopathic remedies, or adjunct therapy remedies, according to the principles of the empirical science of homeopathy and those adjunct therapies.
Client also agrees to read and sign both this form and our Basic Information form before acting and/or considering any recommendations.
Client understands and agrees that any Skype consultations or phone calls while from another state or country are treated as a consultation in our offices here in California. We are not, and can not be aware of all the licensing procedures in other states or countries and it is solely the client’s responsibility to maintain we are within the law of those other states or countries. The client again understands that all information is completely non-medical in nature and the client is personally responsible for any actions taken from use of such information from any source at any time and under any situation.
This agreement shall remain in effect, unless terminated by notice from either party to the other. Client agrees to compensate Ron Frank, D.H.M. for his time with a payment of $200 for the initial visit, and $80 for any follow-up consultations. Short telephone consultations lasting no more than 15 minutes for established clients, are $40. All currency is in standard U.S. dollars. Although we allow for cancellations and rescheduling (due to the length of our consultations) if we are not notified by phone call specifically at 661-274-4449, 48 hours previous to the appointment date then any fees previously paid are forfeit to us from the client at our discretion. It is understood that the same fees and rules apply for office, phone, or Skype consultations.
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Signed by tom snops Frank
Signed On: October 20, 2016
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Document Name: Retainer Agreement for Homeopathic Practice
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