Written informed consent. Consultation Dr. Prachiti Kinikar Patwardhan


WRITTEN INFORMED CONSENT AND INFORMATION FORM

 

This document is for you to give your consent to receive Ayurvedic care. You may withdraw this consent at any time. Signing it does not oblige you to follow the recommendations. Your refusal will not have any consequences for the quality of the rest of the care you receive. Before signing, it is important that you read the following information.

Let us know if you have any questions or need more information. We will be pleased to help you.

 

1. WHAT YOU SHOULD KNOW 

WHAT THE CONSULTATION IS ABOUT. WHAT IT IS FOR

The Āyurveda consultation consists of an in-depth interview. Inspection and examination (pulse, tongue, skin, general appearance, noises, etc.) complement the information to establish a clinical judgement and a plan of action. In the "online" consultation, some examinations will not be possible, which will be compensated for through the interview and inspection. The average duration of the first consultation is one hour.

This consultation serves to get to know the nature of the patient (prakṛti) and the health problem that manifests itself (vikṛti). But you are free to ask any questions you may have.

HOW IT WILL BENEFIT YOU

The aim of the Ayurvedic consultation and the information you receive is to alleviate or suppress symptoms, to combat the source of the health problem, and to provide physical and mental well-being. Advice will focus especially on diet and lifestyle habits. It is also common to receive indications for infusions, decoctions and ointments.

You may receive information on the usefulness of specific Ayurvedic products*.

* Ayurvedic products are legalised in India and meet local safety and quality criteria. But please note that most of these products do not have a legal registration in Spain. Dr. Prachiti Kinikar-Patwardhan and Escuela Superior de Ayurveda do not market these products and decline any responsibility for their use.

WHO WILL ATTEND YOU

Dr. Prachiti Kinikar-Patwardhan is a graduate in Medicine and Surgery Āyurveda (BAMS) from the University of Pune (India), practising in her country with Registration Number I-29124-A-. In recent years she has worked as a teacher and international consultant, and currently directs "The Ayurveda Institute" (Pune, India). In Spain she has been teaching in numerous courses and workshops, as well as directing pañcakarma programmes. He has recently published his first book "Ayurveda Esencial" (Mandala Ediciones).

In India, the BAMS qualification is an official qualification for medical practice according to the principles of Āyurveda. However, this qualification is not recognised in Spain. Therefore, Dr. Prachiti Kinikar-Patwardhan cannot be considered a health professional in Spain.

Her recommendations do not replace the indications and prescriptions of health professionals, and you are responsible and free to follow or reject them.

WHAT ARE THE RISKS OF ĀYURVEDA?

The application of the recommendations you receive should not cause you any significant discomfort. If this is not the case, discontinue use. Exceptionally, Ayurvedic products may cause hypersensitivity reactions (hives, inflammation, etc.). In this case, discontinue the intake or application of the product. Procedures known as pañcakarma and certain techniques and products may be contraindicated in some patients.

SPECIAL SITUATIONS TO BE CONSIDERED

Always inform about the pathological history and the medication you are taking.

 

2. INFORMED CONSENT  

In the case of MINORITY OR DISABILITY, the consent of the legal representative will be required.

DETAILS OF THE PATIENT AND LEGAL REPRESENTATIVE IF APPLICABLE

First name and surname:

DNI/NIE/PASSPORT:  

               

Name and surname of the legal representative:

DNI/NIE/PASSPORT:        

PROFESSIONALS INVOLVED IN THE INFORMATION AND CONSENT PROCESS

Name and surname: Prachiti Kinikar-Patwardhan.            

CONSENT:

  • I consent to the consultation on the terms set out in this document. I have read and understood the information, and have been able to ask questions and clarify any doubts.
  • I consent to the collection of health-related information by written and graphic means. All information you provide will be subject to the provisions of the General Data Protection Regulation (GDPR). The data controller is the "Centro de Estudios Ayurvédicos", RNA Group 1, Section 1, no. 590680.   
  • I authorise the use of information for teaching purposes or for the dissemination of scientific knowledge. Identity will always be kept confidential.
  • I have therefore made a conscious and free decision to give my consent and authorisation in relation to the above points. I am also aware that I may withdraw my consent at any time I deem appropriate.

 

THE PATIENT OR LEGAL REPRESENTATIVE

Signed:

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Nombre del documento: Written informed consent. Consultation Dr. Prachiti Kinikar Patwardhan
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19 November, 2021 18:09 CETWritten informed consent. Consultation Dr. Prachiti Kinikar Patwardhan Subido porEscuela Superior de Ayurveda -info@esayurveda.com IP90.167.158.39
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