Homeopathy Client Agreement Form
Practitioner Details
Name: Sarah Heczko, MA, MSc, LCHE
Email: serenitybsarah@gmail.com
About Homeopathy
Homeopathy is a gentle, holistic system of support that works with your body’s natural processes. It is not a substitute for medical diagnosis or emergency care.
I do not diagnose medical conditions or prescribe medication. You are encouraged to consult your GP for any medical concerns, including coming off any prescription medicines they have prescribed.
Confidentiality
All information shared during consultations is kept strictly confidential.
Your personal and health information will never be shared with third parties unless:
You give explicit consent, or
There is a legal obligation to do so
Data Protection
Your data is handled in accordance with the General Data Protection Regulation.
Your information is stored securely and password protected
It is only used for the purpose of providing homeopathic support
You have the right to access, amend, or request deletion of your data at any time
Record Keeping
Client records are kept securely for 7 years after the end of treatment, after which they are safely deleted or anonymised.
For clients under 18, records are kept until age 18 plus 7 years. This is to protect both you, the client and myself, the practitioner in the case of any legal action.
Remedies
Any remedies suggested are part of a complementary approach and are not a replacement for medical treatment.
You are responsible for informing me of any medical conditions or medications you are currently taking.
Responsibility & Consent
By signing below, you confirm that:
You understand the nature of homeopathy
You take responsibility for your own health decisions
You consent to your information being stored and used for the purposes of your care
Signature: ___________________________
Name (printed): ______________________
Date: _______________________________
By booking a session, you confirm that:
You have read and agree to the Client Agreement
You consent to your data being stored and used for homeopathy support
You understand how your data is handled (see Privacy Policy)