Intake and Consent Form

This form is being given to you to provide information regarding my client/practitioner relationship and to outline my ethical practices as an herbalist. After reading this you will then be able to make an informed decision as to whether you would like to consult with me regarding your health concerns, and what you personally would like to gain from working together.

The information you submit on this page is secured on an encrypted server in Switzerland, which has the most protective privacy laws. Any printing that is done is held in a safe when not in use.

The Role of the Herbalist

As an Herbalist, my ultimate goal is to educate and empower you to reach your health goals. To do so we will approach our sessions from a nutritional, lifestyle and Herbal perspective, which is essential to wholistic health.

My belief is that our body is innately capable of healing itself and with an individualized herbal lifestyle protocol that is properly used; the body can then be supported to return to a healthy, balanced state.

I do not diagnose or directly treat disease. I do however focus on educating you, the client, on how you can personally enhance your body’s own innate healing capacity.

All client records are confidential and will only be discussed with you unless you specifically request otherwise. I will be glad to share with you any questions or concerns you may have regarding my training, credentials and experience. If I feel that your needs and wishes are beyond my training and expertise I will refer you to another practitioner.

I encourage and support any additional consultations you may wish to pursue especially in the diagnosis and treatment of your health condition.

Client Rights and Responsibilities

Payment is due at the time services are rendered. Taya offers several services. Initial Consultation fee is $120 for up to 2 hours. Follow-ups are $60 for up to an hour. Rife sessions are $30 in person and $20 remote per session. Payments can be made by cash or e-transfer to Missed Appointments except for emergency situations, without 24 hour notice result in a $30 cancelation fee.

Some formulas and suggested product can be purchased from my Apothecary. Please note you are not obligated to do so and may purchase all or any products elsewhere. You have the right to courteous and respectful care. At any time you may choose to no longer follow any or all of the recommendations provided to you as a result of this consultation. You have the right to consult with another practitioner and all records will be provided upon written request.

Note about Covid-19 "Vaccines"

Due to the experimental nature of the pharmaceutical products marketed as Covid 19 vaccines, the long term safety and effectiveness of these treatments have not been determined. Data of the adverse effects is still being collected, and the complications from these experiments are extensive and still unknown.

In completing the form below, you agree that any symptoms associated with this experimental treatment cannot and will not be attributed to herbal recommends given by Taya even if the symptoms arise months or years after having received the treatments marketed as Covid 19 vaccines.

Herb Safety

As with anything one takes for their health, they must educate themselves. Throughout history and even through modern research, most herbs that are used for healthcare have excellent safety reports. Herb and drug interactions are rare, but possible. Herbs should not be taken during pregnancy or lactation without expert advice. If you should become pregnant while taking herbs, stop taking them immediately and seek professional advice. For your safety, it is also your responsibility to fully disclose any medications, herbs, and/or supplements you are currently taking so that you can be offered informed advice. Any suggestion that the effect of a drug is being altered by simultaneous use of an herb should be reported to all health professional involved.

If you are scheduled to have surgery or have been prescribed anticoagulants, anti-epileptic drugs and/or digoxin, it is advisable to stop taking all herbs and supplements at least 72 hours prior.

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