Consent to Chinese Medicine Purchase and/or Treatment

Patient Consent

Classical Chinese Medicine is a traditional system of health care that includes but is not limited to herbal supplements, dietary and lifestyle advice. As with any health care treatment, it is important that you read and understand any potential risks that may be associated with Chinese medicine so that you may properly consider the risks and benefits that may apply to you. Most commonly, these are a temporary reaction that the body goes through while eliminating toxins and finding balance, but sometimes they are a negative side effect that should be addressed.  Despite being considered an effective and safe system, in some cases patients could experience rare and/or mild side effects. These may include, but are not limited to: changes in bowel movements, stomach ache, possible aggravation of preexisting symptoms, nausea, vomiting, dizziness, rashes, hives, tingling of the tongue or headaches. Chinese herbal medicine, practiced by a licensed practitioner, is generally considered a safe modality, but for this to be the case the patient must diligently inform their practitioner of all relevant health information. It is possible to experience side effects and possible interactions between herbal supplements and conventional medications. It is important that you discuss with your practitioner your medical history, current medications, supplements, vitamins, herbs, minerals and any other non-food health related product that you are currently using. It is important that you update your practitioner immediately if this list changes. It is also important to notify Hayley Gardner LAc immediately if you experience any uncomfortable symptoms that may be considered side effects once treatment has begun.

I understand that the natural substances used in Estuary Herbs’ products and formulas are based on the traditional system of Chinese Medicine, and have a millennia-strong historical and anecdotal basis for use, as prescribed today. I understand that Hayley Gardner LAc is a licensed practitioner of Chinese Medicine and adheres to the traditional teachings of this system, and that all advice and products given fall strictly within her scope of practice. I understand that I am not required to take these substances, but if I choose to do so I must follow the directions for administration and dosage as given to me by Hayley Gardner LAc. Estuary Herbs Co and its employees are in no way responsible for my failure to adhere to instructions. 

I understand that efficacy of treatment and advice given is dependent on my compliance and honest and full disclosure in response to all questions asked during my Chinese medicine consultation, whether completed in written or oral form. 

Certain Chinese herbal formulas and modalities within the scope of Chinese medicine may have an effect on pregnancy. I agree to inform Hayley Gardner LAc immediately if I become pregnant or suspect possible pregnancy. If I am unable to communicate this to Hayley Gardner LAc I will discontinue my herbs until an amended pregnancy-appropriate treatment plan is put in place. 

I understand that some herbs used in Chinese medicine can be considered toxic in inappropriate or large doses and I must adhere strictly to the dose recommendation given to me by my practitioner. I do not expect Hayley Gardner LAc or Estuary Herbs Co to be able to anticipate and explain all possible risks and complications of treatment, and I wish to rely on her to exercise professional, informed judgment during the course of treatment to make decisions that are in my best interest, based upon the facts then known.

I understand that any diagnosis given within the context of Chinese medicine treatment does not constitute a Western or Conventional medical diagnosis. Any advice given during the course of my practitioner/patient relationship with Hayley Gardner LAc is not intended to replace the advice of my primary care physician and is intended for educational purposes only. It is my responsibility to seek medical care with a licensed medical doctor for any medical conditions, and in no way is Hayley Gardner LAc or Estuary Herbs to be held responsible should I neglect to do so.

I understand and explicitly consent to the relevant staff of Estuary Herbs Co to review my medical records when strictly necessary for the purposes of fulfilling my order and executing my care, but that all records will be kept confidential in accordance with HIPPA privacy laws and will not be released in any way without my written consent.

By submitting this form, I show that I have read and understood it contents and consent to treatment. I have been told about the risks and benefits of Chinese medicine and have been given the opportunity to ask questions. I further understand, as with any medical treatment, that that there are no guarantees made as to the results of the treatment. This consent form shall cover the entire course of the practitioner/patient relationship I retain with Hayley Gardner LAc and Estuary Herbs Co.

Practitioner Consent: 

As a Licensed Chinese Medicine Practitioner utilizing the Consulting Services or Herbal Dispensing services of Estuary Herbs Co, I understand that it is my responsibility to obtain consent of my patients to the terms and conditions of this consent form and by placing an order I agree that I have done so and consent to the terms and conditions outlined in this document. Estuary Herbs Co or it’s employees are not in any way liable for monitoring my patients in regard to their herbal or Chinese Medicine treatment or for anticipating a need that may arise during the course of my patient’s treatment, it is my responsibility to monitor and communicate with my patient and report changes in their condition that are relevant to the course of their herbal treatment to Estuary Herbs Co when utilizing Estuary Herbs Co herbal consulting services. I understand that Estuary Herbs Co is operating as a independent consultant that I have engaged the services of to provide educational information on the topic of Chinese medicine and Herbal Medicine. It is my responsibility to safely utilize this information and to monitor and guide my patients in best practices. 

Exchange and Return Policies:

Due to the individualized nature of custom Chinese herbal medicine, we are unable to offer returns, exchanges or refunds on any custom herbal formulas, Herbal Consultations or other services. 

For Over The Counter herbal products, we can offer store credit on unopened, safely sealed, as-new products subject to the discretion of Estuary Herbs management. If seals are in any way broken or tampered with, if bottles or packaging is damaged or otherwise considered tampered with we reserve the right to decline exchanges. 

Shipping Policies: 

Domestic Shipping Policy

Shipment processing times

All Orders are processed within 2-3 business days. Orders are not shipped or delivered on weekends or holidays. 
 

If we are experiencing a high volume of orders, shipments may be delayed by a few days. Please allow additional days in transit for delivery. If there will be a significant delay in shipment of Your Order, We will contact You via email or telephone.

Shipping rates & delivery estimates
 

Due to the wide variety of product weights and sizes offered, shipping estimates generated by carriers at checkout may not be accurate. In order to reduce the incidence of shipping changes, We offer an "Estuary Herbs Shipping" Flat Rate. When You select "Estuary Herbs Shipping" at checkout, You are consenting to allow Us to choose the carrier, method, and speed for shipping your order. If You choose an option other than "Estuary Herbs Shipping," You are aware that the quoted rates may not be accurate, and that We reserve the right to delay shipping until We have collected the necessary payment from You. Overnight delivery is only available for Orders with delivery addresses within the continental United States. Estuary Herbs Co does not make any guarantee as to any delivery speed.
 

International Delivery
 

For delivery outside of the continental United States, We will only use DHL. Expedited shipping is available with DHL, but this is not generally an overnight option.

Shipment to P.O. boxes or APO/FPO addresses

Estuary Herbs Co ships to addresses within the U.S., U.S. Territories, and APO/FPO/DPO addresses. We do not ship to P.O. Boxes.

Shipment confirmation & Order tracking

You will receive a Shipment Confirmation Email once Your Order has shipped containing your tracking number(s). The tracking number will be active within 24 hours.

Customs, Duties and Taxes

Estuary Herbs Co is not responsible for any customs and taxes applied to Your Order. All fees imposed during or after shipping are the responsibility of the customer (tariffs, taxes). These will be collected from You by the carrier.

Damages

Estuary Herbs Co is not liable for any products damaged or lost during shipping, however as a courtesy we will replace lost or damaged items and file an insurance claim on your behalf. In order to do this, if you received your order damaged, please save all packaging materials and damaged goods, take multiple photos of the package and goods, and contact us immediately for further instructions. 

Contact Us

If you have any questions about this Shipping Policy, You can contact Us by sending an email to help@estuaryherbs.com