Patient General Consent Form

Fields marked with an * are required

Understand that:

  • Some of the accessory functional pathology tests, treatments and products administered by practitioners at Dr Jaa's Medical Health may be outside the parameters of conventional medicine in Australia.  They include IM, IV and PR applications.
  • These tests, treatments and products fall into the category of Natural or Complementary Medicine.
  • These functional tests, treatments and products are supported by empirical knowledge and in many cases by research data.
  • That these tests, treatments and products are safe, are widely and successfully used by Integrative Medical Practitioners in Centres in Australia and overseas, and are only prescribed with utmost care.
  • Some functional pathology tests and treatments offered at Dr Jaa's Medical Health are not covered by Medicare or private health insurance funds.
  • All Dr Jaa's Medical Health practitioners are members and active participants of their respective professional colleges.
  • I also understand that practitioners benefit either directly or indirectly from tests recommended at this practice.
  • The treatment may not be regulated by the TGA (Therapeutic Goods Administration).

I am attending Dr Jaa's Medical Health of my own free will and consent and exercise my right to discuss and choose any useful and suitable treatment(s) made available to me.

Information obtained at the clinic can and may be used de-identified for research and publication.


Employees of Dr Jaa's Medical Health and RPPR are independent health contractors.  Therapy not endorsed by Dr Jaa or Dr Jaa's Medical Health as way of written referral is considered the legal responsibility of the independent contractor.