This agreement helps us create a foundation of trust and collaboration for your healing journey. It reflects our shared intention to work together with commitment, communication, and mutual respect as we move toward balance, transformation, and wellness.
Patient Commitment Agreement
At 4 Winds Medicine, I am committed to providing individualized, holistic care to support your healing journey. Your active participation and dedication to the treatment plan are essential for achieving the best possible results. Healing is a collaborative process, and your commitment helps create the environment needed for meaningful, lasting change.
Your Commitment
True healing is a journey, not a quick fix. It unfolds over time as your body, mind, and spirit begin to realign. Some changes may feel subtle at first, while others bring noticeable improvements right away. There may also be moments of discomfort or emotional release as your system adjusts. These shifts are a natural part of the process and often indicate that healing is occurring at a deeper level. By remaining consistent with your treatments, self-care practices, and lifestyle adjustments, you allow your body to build momentum and restore balance from within.
- I agree to attend all scheduled appointments consistently and on time.
- I will follow my treatment and self-care recommendations as discussed.
- I will communicate openly about my progress and any challenges I experience.
- I understand that healing is a process that requires patience, consistency, and trust in the journey.
E-Signature Acknowledgment
By signing below, I acknowledge my active role in my healing journey and understand that meaningful change develops over time through consistency, dedication, and openness to the process.
Full Name: ____________________________
Date: ____________________________
Signature: ____________________________
Please print, sign, and return this form via email prior to your first appointment, or bring a signed copy with you to your first session.
