Acute Care Form

Please fill out this form to book your Acute Call. After filling out the form there will be a payment link for $50. This payment provides you up to three days of care.
I prioritize already established client needs, and will give you a call at my earliest convenience.

NameEmail AddressPhone NumberPlease give a brief description of who needs care, their age, main concerns and symptoms, date symptoms began. List any other medications or remedies that have already been given.

SWEETGRASS HOMEOPATHY ACUTE CARE CONSENT:

Homeopathy views health from a holistic perspective. Bethany Huss is a homeopath and not a medical doctor and does not make any sort of diagnosis in medical terms and it is your responsibility to maintain a relationship with a licensed physician or primary care provider for appropriate evaluations and check-ups.

***Under no circumstances should any suggestions be taken as a medical diagnosis or direction against a licensed medical or mental health care professional.***

By agreeing to our terms of service you agree to the following:I understand that the goal of homeopathy is to increase my (my child’s) general vitality and constitutional strength and that no specific disease will be diagnosed or treated.

I authorize discussion of my case notes with other professional Homeopaths if my (my child’s) best interests are served by such a consultation. My right to privacy will be protected by withholding my name and any other identifying information. I am over 18 years of age and have voluntarily chosen homeopathic treatment for myself/my child.

I am aware that the outcome and duration of homeopathic treatment vary by individual and cannot be guaranteed and that Sweetgrass Homeopathy and Bethany Huss further offer no warranty or guarantee as to the outcome of the homeopathic treatment. I agree that I have a choice with regard to where I obtain homeopathic medicines recommended.

I waive all legal rights that may arise from the homeopathic treatment and hold the assigned Homeopath harmless from all claims, present and future, known or unknown, in any manner arising out of the homeopathic treatment.

The Parties agree that the terms and provisions of this agreement embody their mutual intent and that such terms and conditions are not to be construed more liberally in favor of, or more strictly against, either Party. If any provision herein is invalid, it shall be considered deleted from this agreement and shall not invalidate the remaining provisions of this agreement. All recommendations are for wellness and overall health building purposes.

Type Name to Consent to Care.

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