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Consent to Receive Treatment

I acknowledge that Natural Endocrinology Specialists (NES) has discussed with me the medical basis for acupuncture/TCM in my case and has discussed the risks and benefits of this therapy with me. I understand that I have the right to a second opinion and to secure other opinions about my circumstances and healthcare as I see fit.

I hereby consent to treatment by acupuncture/TCM and certify that I understand the nature of this treatment, including the risks of possible complications and choices I may have about other approaches. I have been adequately informed, questions I have asked have been satisfactorily answered, and I have executed this consent voluntarily and of my own choice. I have not been offered any guarantee as to the outcome. I have given my provider at NES all of the information they need to make treatment decisions in my case.

I represent that I am seeking treatment in order to further my own health and for no other reason. I do not represent a third party. I acknowledge receipt of a copy of this consent should I request it.

Dr. Linda Khoshaba is the Leading Integrative Health and Hormone Doctor in Scottsdale, Arizona. She has extensive experience working in the field as a Hormone Specialist and Natural Endocrinologist.

7500 E. Pinnacle Peak Rd. Suite A 109
Scottsdale, AZ 85255

Mon: 8:30AM - 4:30PM
Tue: 8:30AM - 4:30PM
Wed: 7:30AM - 4:30PM
Thu: 8:30AM - 4:30PM
Fri: 8:30AM - 3:30PM
Sat - Sun: Closed
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