Maria Williford, BSN, Clinical Herbalist

Water’s Edge Herbalist

Morgan, UT 84050

801-845-0693

 

This form is intended to provide you with information regarding our client/herbalist relationship as we enter into a healing partnership.  It will outline the standards of practice of an herbal consultant and the responsibilities of you, the client.  With this information, you can make an informed decision of whether you would like to consult with me regarding your health concerns and what your goals are in seeking this care.

 

The Role of the Clinical Herbalist

My primary role as your herbalist is to be an educator and a partner in your health goals, encouraging and empowering you to reach your goals for improved health and well-being.  Every person is unique physiologically, emotionally, and energetically.  Through my consultation, each client will be viewed as a whole person, looking at your physical, emotional, spiritual, nutritional, and lifestyle health.  Herbal practice is based on the belief that the human body is a resilient and intelligent system that is innately self-healing and adaptive.  I will consider your individual constitution to craft specific herbal, dietary and lifestyle recommendations to support and encourage your body to return to a healthy state.  

 

Clinical Herbalists are not licensed practitioners and are not regulated by the State of Utah.  I am not a medical practitioner or mental health practitioner.  I do not diagnose, treat, correct, or prescribe for any human disease, ailment, injury, infirmity, deformity, pain or other condition. I will not recommend a client discontinue or change any current medical treatments, procedures, or pharmaceuticals that a medical practitioner has recommended.  This consultation is not intended to replace medical care and the client shall seek medical treatment from a licensed health care practitioner as needed.  If I feel that your needs are beyond my training and expertise, I will gladly refer you to another practitioner.  

 

Client Rights and Responsibilities

All client files are confidential and will only be discussed with you unless you request, in writing, otherwise.  I am excited to be a part of your health care team.  I support and encourage your right to consult any practitioner of your choice.  I am willing to work with your physician or other health care providers, if you choose.  

 

It is your right to decide how to care for your health.  I will work with you in the development of any recommendations to reach your health care goals.  It is your choice to make any of the changes, use any of the herbs or supplements recommended during the consultation and will not hold Maria M. Williford or other persons responsible for any consequences of such a decision.  

 

Payment is due at the time services are rendered.  If any herbs or supplements are suggested, we will make a plan to facilitate your access to the herbs or supplements.

 

Herb Safety

Use of herbal medicine may affect people differently.  The duration of use varies and there is no stated or implied guarantee of success or effectiveness after a specific use or period of time.   Throughout history and modern research, most herbs used for wellness are considered to be very safe.  Herb-drug interactions are rare but possible.  Still, any adverse event can occur while taking any active substance.  For your safety, it is important that you have disclosed all allergies, medications, drugs, herbs, and supplements you are currently taking so that informed advice can be offered.  If you feel any unexpected changes as a result of the herbs you are taking, or suspect the effects are not what they should be, stop taking the herbs and contact me and any other health care professionals involved.  It is also recommended to stop taking herbs at least 72 hours before surgical operations.  In the event of being prescribed anticoagulants, anti epileptic drugs, or digoxin, stop all herbs immediately and seek further advice from your health care provider or clinical herbalist.

 

Herbs should only be taken during pregnancy or lactations with the advice and guidance of someone who specializes in pregnancy and/or lactation.   If you become pregnant, you should stop taking all herbs until specialized advice is received.

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I have read this document and understand the nature of the client and herbalist relationship.  I voluntarily consent to an herbal consultation.  I have completed the patient information form completely and accurately.  I understand and accept the risks involved in care.  I understand there are no guarantees made or implied regarding use of herbal or nutritional supplements or natural health methods.  Achieving wellness requires my commitment to my own good health whether through diet, exercise or lifestyle changes.  I understand that at any time I am free to discontinue service with Maria Williford.  I understand that an herbal consultation is not a substitute for regular medical care but can offer guidance and education so that I may better understand and heal myself.  I agree to consult with a licensed medical provider for any serious or life threatening disease.

 

**(Complete form will be electronically sent to clients for signing prior to initial consultation)**

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