Last Updated On 11-Nov-2025
Treatment Agreement
The undersigned hereby gives consent for mesological treatment at Integrative Health Clinic.
This consent remains valid until it is withdrawn, or until the treatment is terminated, with due observance of the prescribed retention period.
By signing this document, you also give the therapist permission to send information such as invoices or other correspondence by email.
The therapist is required to act in accordance with legal regulations. The rights and obligations of both client and therapist are laid down, among others, in the Medical Treatment Agreement Act (WGBO) and the Quality, Complaints and Disputes in Care Act (Wkkgz).
The therapist keeps a client file. The client has the right to access their own file. The file is retained for a total of 20 years in accordance with the statutory retention period. See PR 520 – File Handling for RBCZ sectors.
The therapist is obliged to provide information regarding the treatment to the client at all stages of the process. The client is obliged, through the anamnesis (intake) interview, to provide the therapist with all relevant information.
The therapist may not perform any mesological treatments or procedures without the client’s consent.
In addition to the therapist’s duty to inform, emphasis is placed on joint decision-making regarding the course of treatment between therapist and client.
The therapist is obliged to refer the client appropriately to a colleague therapist or physician if mesological treatment is not suitable and/or sufficient.
Termination of treatment may take place at any time by mutual consent. If the client no longer wishes to continue the treatment or considers it unnecessary, he/she may terminate it unilaterally. The therapist may terminate the treatment unilaterally only by stating reasons and, if necessary, referring the client to another therapist, doctor, or other healthcare professional.
You have read the Privacy Statement, as published on this website and you agree to this statement.
You have read the General Terms and Conditions of Integrative Health Clinic, as published on this website and you agree to these terms.
The client agrees to the consultation rates listed on this website. Payment for treatments is made via payment request or in cash.
The client is obliged to cancel an appointment in time (at least 48 hours in advance). Appointments cancelled within 48 hours will be charged in full.
For complaints about the treatment, the client may contact the complaints officer of the VBAG: https://vbag.nl/consument/klachten-en-geschillen/.
All possible adverse consequences resulting from withholding information contained in the medical file held by the general practitioner are the responsibility and liability of the client.