Homeopathy views health and illness in a holistic manner and this view is different from the
standard, conventional approach which usually limits its concerns to individual symptoms. In
working with the whole person the homeopath regards the mental and emotional as well as physical
aspects as important. A minor aggravation or worsening of some symptoms may occur as a part of
the general healing process.
Confidentiality
I understand that all information disclosed is confidential and may not be revealed to anyone
without written permission, except where disclosure is required by law. Disclosure may be required
in the following circumstances: a reasonable suspicion of child or elder abuse; a reasonable
suspicion that a client presents a danger to him or herself or to others.
Consultation
I authorize discussion of my case notes with other professional homeopaths should assistance in
remedy selection and/or symptom analysis be required (for myself or my child) or my best interest
be served by such a consultation. In so doing, my right to privacy will be protected by withholding
my name and all other identifying information.
Consent
I am 18 years of age or older and have voluntarily chosen homeopathic treatment for myself. I
understand that Vimal Patel  is a homeopath and not a medical doctor, and it is therefore
recommended that I retain the services of a primary care physician for appropriate evaluations and
check-ups for myself. I further understand that Vimal Patel does not diagnose, treat or
prescribe for any particular symptom, disease or condition. I understand that he/she will work on
increasing my general vitality and constitutional strength.

PRACTITIONER-CLIENT GOOD FAITH ACKNOWLEGEMENT
This is to notify the client who prints the name on the form below that Vimal Patel is a Homeopathic Practitioner who abides by laws, ethical practice guidelines, confidentiality and professional conducts as stated in many homeopathic organizations such as Registered Homeopaths in North America. I understand that the treatment with Homeopathic remedies only involves energy from natural substances and that it does not have any drugs. Many remedies such as the spinal remedy is created by Vimal Patel and used personally by him and many other's which includes natural herbal remedies converted to homeopathic remedies, which is not described in any materia medica yet. Disclosures of names of such remedy mixture such as the spinal remedies is waived by the client to prevent copying. I understand that I will not request any remedy names or force the practitioner to disclose any remedy names used to treat my imbalanced energies in my system. I accept if I have provided any hair sample to conduct polarity analysis, general health analysis the homeopathic way when required and as treated by my practitioner. Homeopathic practice is governed by many homeopathic organizations and not by FDA. Homeopathic remedies do not have any actual substance in it they just have potentiated energy which may cause aggravation of my condition, which is temporary and a good indication of a correct similar remedy to your state Additionally a closely matching remedy to you the client may cause discharges through normal bodily discharges and may bring a suppressed fever or old symptoms to surface. This happens then it needs to be addressed with different remedy or may require you to visit your physician. Please understand you must take due diligence in seeking treatment any appropriate way like your physician and or homeopaths  . The Physician is considered to be only practitioner who can conduct medical diagnosis and treatments and I am seeking additional help from Homeopathic practitioner to heal my energy system. I understand the homeopathic practitioner is not a medical doctor to treat diseases. I understand that my health issues are treated by homeopathic practitioner the traditional, classical, sensational methods of practice with energy from natural remedies. I understand that my hair sample is required to further the analysis of my energy imbalance and fine tune the vital force in me or also called as Prana. Everything in this planet has a unique energy system associated with it I understand that my practitioner uses radionics to analysis and create a unique prophylaxis just made for me.
I understand that if required I may seek immediate medical attention such as hospitals or my physician office to treat immediate health care needs. I understand My practitioner Vimal Patel is a part time practitioners and may not be available to attend to my urgent needs. I understand that my practitioner is only a tele homeopathic practitioner and may not be available to meet personally. All consultations are recorded for review purposes. I understand the fees are due immediately before consultation. Only the special tier consultations clients may know the remedy names immediately when mailed to them. Eventually all tiers may be informed at the end of the treatment about what remedies where used in treatments except certain special remedies such as spinal remedy mixture and anti-cancer protocol remedy created solely by my practitioner.  All homeopathic treatments are an attempt to find a in depth remedy for your energy imbalance, this does not mean you are guaranteed a Similimum (exact similar remedy to you to what's out in the world in different forms and shapes like minerals, plants, animals, fungi, five thousand and more remedies) immediately in the first case analysis, follow up are required for repeat treatments or newer layer analysis. Rarely the same dosage of energy is used for repeat treatments, a change in energy is required to expedite healing process. Additionally you agree if you are unhappy with the service you receive the maximum reimbursement back to you is about fifty percent of fees paid after the third visit if provided I did not see a satisfactory improvement . Documentations required from homeopath will incur additional cost.
YOU THE CLIENT HEREBY AFFIRM THAT YOU WILL NOT COPY THE REMEDIES BY ANY MEANS, DISTRIBUTE, SHARE OR RUN ANALYTICS BY ANY MEANS DOING SO INFRINGES THE PROPERTY OF VIMAL PATEL HOMEOPATH SERVICE AND OR VIMAL PATEL REGISTERED HOMEOPATH AND OR PATEL'S HOMEOPATHY CONSULTATIONS LLC this may result in strict legal actions.
This remedy are created to help you to the best of my knowledge.
Homeopathic hair analysis may be required in follow up appointments for polarity analysis of your constitution to the remedies selected. It also provides information on nature of issues. Many analysis can be run with hair sample. Chakra remedy and Stress relief remedy is created using your hair sample

You accept the agreement above  please print your name as a signature .