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California Health Freedom Act Disclosure Download a copy of this Disclosure Form (PDF) Homeopathy is considered an alternative therapy and is not a substitution for medical treatment. The information and therapy offered by Gail Wilson, Classical Homeopath for her homeopathic services does not include a diagnosis. Homeopathic remedies are available over the counter and are FDA approved. 1) In compliance with Section 2053.6 of Senate Bill SB577, Gail Wilson, Classical Homeopath, herewith discloses the following: a) That she is not a licensed physician. b) That the treatment is alternative or complementary to healing arts services licensed by the state. c) That the service to be provided is not licensed by the state. d) That the nature of the service to be provided is Homeopathy. e) That the theory of treatment upon which this service is based is the Science of Homeopathy, practiced in accordance with the advanced methods of the Fifth and Sixth Editions of Samuel Hahnemann’s Organon of Medicine. f) Education, Training, and Professional Experience Schools – Caduceus Institute of Classical Homeopathy, current enrollment Homeopathic Studies - Renaissance Institute of Classical Homeopathy (R.I.C.H.) Professional Affiliations – The National Center for Homeopathy, member Repertories - Kent, Boenninghausen, Hering Materia Medicas - Vermeulen, Tyler, Allen, Kent, Boenninghausen, Hering Forums - Caduceus Students, Homeopathy For Women, Homeopathy Study, RICH Roundtable, Templiers Organon I hereby accept full responsibility for any actions taken by myself or my child concerning any foods, homeopathic remedies, herbs, supplements, exercises, and educational therapies with Gail Wilson, Classical Homeopath. I hereby release the aforementioned from any liability resulting in any possible damages or loss during our association. I understand that rather than medical advice or treatment, I am seeking alternative treatment in the form of lifestyle, educational, nutritional, and homeopathic advice and/or recommendations. Under no circumstances, should any suggestions be taken as a diagnosis or direction against a licensed physical or mental care professional. I affirm that I am seeking self-help advice in natural health or educational matters only, and if I desire a diagnosis or treatment for any medical condition, I must consult a physician. I acknowledge that Gail Wilson, Classical Homeopath is not a medical institution, medical doctor or licensed practitioner. I understand that Homeopathy is considered an alternative therapy and is not a substitution for medical treatment. The information and therapy offered by Gail Wilson, Classical Homeopath for her homeopathic services does not include a diagnosis. Homeopathic remedies are available over the counter and are FDA approved. I acknowledge that I have read and understand all that is disclosed herewith. Signature ___________________________________________________ Date_________________________________________________________ Printed Name _________________________________________________ Child’s Name __________________________________________________
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