drdorwal
  • Home
  • Homoeopathy
    • What is Homoeopathy?
    • My Clinical Approach
    • The Healing Process
    • Patient Care Guide
  • Health Guide
    • Diseases
    • Yoga
    • Diet
    • Medicines
  • Health Solutions
    • Asthma & Allergies Solutions
    • Kidney Stones Solutions
    • Digestive Issues Solutions
    • Skin Care Solutions
    • Hair & Scalp Solutions
    • Joint & Back Pain Solutions
    • Metabolic & Lifestyle Disorders Solutions
    • Women Health Solutions
    • Headache & Migraine Solutions
  • Disclaimer
  • About
  • Home
  • Homoeopathy
    • What is Homoeopathy?
    • My Clinical Approach
    • The Healing Process
    • Patient Care Guide
  • Health Guide
    • Diseases
    • Yoga
    • Diet
    • Medicines
  • Health Solutions
    • Asthma & Allergies Solutions
    • Kidney Stones Solutions
    • Digestive Issues Solutions
    • Skin Care Solutions
    • Hair & Scalp Solutions
    • Joint & Back Pain Solutions
    • Metabolic & Lifestyle Disorders Solutions
    • Women Health Solutions
    • Headache & Migraine Solutions
  • Disclaimer
  • About

Patient Consent Form

  • Home
  • Patient Consent Form
Before Your First Consultation

Patient Consent Form

Please read each point carefully, fill in your details, tick every box to confirm you understand and agree, then submit. A copy will be generated for your records and ours.

Patient Details

Declarations — please confirm each

01I understand that homoeopathy is a distinct system of medicine, and results vary from patient to patient depending on individual constitution, disease stage, and compliance.

02I understand that where my condition has been declared incurable, chronic/lifelong, terminal, or without a definitive cure by mainstream medical science, Dr. Dorwal does not guarantee, promise, or claim to cure it. Any treatment offered to me for such a condition is supportive/palliative in nature, aimed at symptom relief and quality of life, and not a promised cure.

03I confirm that the medical history, current diagnoses, ongoing medication, and reports I have disclosed are complete and accurate to the best of my knowledge.

04I will not stop or alter any medication prescribed to me by another physician/specialist without first consulting that physician, even while undergoing homoeopathic treatment.

05Where this consultation is conducted via telemedicine, I understand its limitations — no physical examination is performed, and diagnosis/advice is based on the information, history and images I provide. I understand the physician may ask me to visit in person if felt necessary.

06In case of a medical emergency, I understand I must seek immediate in-person emergency care and will not rely on tele-consultation for emergencies.

07I consent to my medical information being recorded and used solely for the purpose of my treatment and kept confidential as per applicable Indian law, and shared further only with my consent or as required by law.

08I am consenting to this treatment/consultation voluntarily, have had the opportunity to ask questions, and understand I may withdraw consent for further treatment at any time.

Declaration Details

On submitting, a PDF copy of this filled form will download to your device. Please keep it for your records; Dr. Dorwal keeps a corresponding copy.

Contact INFO
  • Dhani Tarani, opp. Shekhawati University, V.P.O. Katrathal (Sikar), Rajasthan (India) - Pin Code: 332024
  • +918769436509
  • chetandourwal@gmail.com
Calendar
August 2026
MTWTFSS
 12
3456789
10111213141516
17181920212223
24252627282930
31 
« Jul    
Medical Disclaimer

The information provided on this website is intended solely for educational purposes and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. Please note that individual treatment results may vary, and in the event of a medical Emergency, Please visit the nearest Hospital or seek Emergency medical care immediately; Therefore, after reading any information on this website, Consult directly with Dr. Dorwal before starting any treatment or plan.

Copyright © drdorwal.com. All rights reserved.
Consult Dr. Dorwal
Scan the code