I have engaged Dr. Anderson, a licensed veterinarian and the Lincolnway Veterinary Clinic or Pawsitive Integrative Veterinary Care to perform integrative and/or holistic treatments or therapies on my animal. The treatment or therapy has been described and explained to me to my satisfaction by Dr. Anderson or one or her associates.
I hereby fully consent to and authorize the performance of such integrative and/or holistic treatment by this facility, including any preliminary, further, or additional treatments, therapies, tests, medications, herbs or injections that may be, in the judgement of Dr. Anderson or any veterinarian associated with her, considered advisable or necessary at any time while the integrative and/or holistic treatment or therapy is being performed.
These treatments or therapies include - but are not limited to -
- Ozone Therapy
- Acupuncture Therapy
- Traditional Chinese Herbal Therapy
- Magnesphere Therapy
- Laser Therapy
- Prolozone Therapy
- Food Therapy
- Homeopathy & Homotoxicology
- Veterinary Medical Manipulation
- Hyperbaric Oxygen Chamber
- Endolaser therapy with Weber laser IV, interstitial or intraarticular
- Other therapies or treatments deemed integrative and/or holistic
The intention of this consent is to grant full authority to Dr. Anderson and any veterinarian associated with her and their respective employees, assistants and consultants, to administer and perform any and all integrative and/or holistic medical, drugs, treatments, tests, medications, injections or diagnostic procedures to my animal that may be deemed advisable or necessary by Dr. Anderson or any veterinarian associated with her.
I have been fully informed, to my satisfaction, by Dr. Anderson that integrative and holistic veterinary medicine does or may be considered by some in the American veterinary profession as a philosophy or practice that does or may differ from current scientific knowledge, or whose theoretical basis and techniques may diverge, even considerably, from veterinary medicine routinely taught in accredited veterinary colleges in the United States.
I understand that integrative and/or holistic veterinary therapy -
- Is not like most conventional or drug therapies, in that it has or may have multiple effects on many systems in an animal at a time
- It may have no effect
- My animal may experience some discomfort from integrative and/or holistic treatments or therapies
- Is usually, but not always safe and it may have side effects that may be the same or more severe than conventional, drugs or other treatments.
- May have adverse effects including, but not limited to, illness, known or unknown interactions, nausea, vomiting, diarrhea, constipation, muscle spasms or more serious, unforeseen effects including, in rare situations, stroke, paralysis or death.
I appreciate that my animal may not respond nor benefit from integrative and/or holistic veterinary treatment. I also understand that it is important for me to fully follow Dr. Anderson's instructions on monitoring my animals such as, but limited to, blood, stool and/or urine tests, over the course of their treatment and promptly and fully report back to Dr. Anderson or any veterinarian associated with her, any adverse effects or unusual behavior.
I further understand that if my animal is seen by another veterinarian not associated with Dr. Anderson or this facility while undergoing or having undergone integrative and/or holistic veterinary treatment that I should fully inform the other veterinarian that my animal is on or has undergone an integrative and/or holistic treatment, the nature of the treatment, and request the other veterinarian to contact Dr. Anderson or a veterinarian associated with her.
