Carol Everett
fm-med US/UK 01.01.06
Consultant Intuitive Diagnostician & Healer
PoundsHill House PoundsHill Crediton Devon. EX17 1AA.
www.everetthealthcare.com
DISCLAIMER
Please Sign & Return PRIOR to Diagnosis... Ensure you also read PRIOR to healing.
I understand Carol Everett is not qualified as a doctor, she does not practice as a doctor and is
not acting in the capacity of a doctor or impersonating a doctor. My consultation with Carol
Everett, a medical intuitive, is entirely on this basis.
I understand Intuitive Diagnosis or healing is not a replacement for conventional medicine or
the treatment available from a qualified doctor. Intuitive Diagnosis irrespective of its
accuracy, remains an unqualified medical opinion. I understand that a doctor, if I shown the
diagnosis details will have the opportunity to check out, and act on the opinion provided.
I am also aware I need to seek 'confirmation' of intuitive diagnosis or the results of healing
by a qualified doctor. However this will remain at my own discretion.
Changes of medication or treatment remain my own responsibility. I will ensure any decisions
regarding this are taken with full knowledge and approval of my own doctor.
I understand as with ANY medical diagnosis or treatment that there can no guarantees offered
and no guarantees are implied, or given.
I assure Carol Everett and her agents that I will make no claim whatsoever, howsoever arising
in relationship to any appointment or diagnosis with her.
a. PATIENTS NAME
ADDRESS
POST AREA CODE
SIGNATURE
: ______________________________
: ______________________________
: ______________________________
: ______________________________
: ______________________________
: ______________________________
DIAGNOSIS DATE :_________________________
BIRTH DATE
:_________________________
TELEPHONE No
:_________________________
: _______________________________ (Patient, Parent or Guardian if patient a minor)
Visa/M.Card.. No...
b. BLIND/SPECIFIC Diagnosis [
]
RESEARCHED Option [
Expiry..
Start..
]
Healing Only [ ]
(Switch issue)
Note.. Diagnosis written notes completion, IF applicable and you requested written notes. Depending on workload, any written part
of your diagnosis may take time to complete, please allow up to 4 weeks for this. This is also only available if also being sent direct
to a doctor. Patients referred by doctors for diagnosis, due to their complexity are usually researched. Also written notes wherever
possible are completed within 1-2 weeks. Blind/Specific diagnosis does not specifically contain written notes. But case note copies
will usually be provided IF a qualified practitioner is checking the diagnosis findings. Please advise.
Nb. Written and Researched diagnosis involves additional charges for research and secretarial time. Only Carol Everett can complete
research work and this cannot be delegated to anyone else. Transcripts of taped diagnosis are completed externally.
Healing for seriously ill patients takes priority at times, this means any extra ordinary delays may be due to emergency work with
healing. Due to the nature of intuitive diagnosis it is not possible to discuss in detail the content of a diagnosis by phone etc outside
of specific appointments. Unlike doctors, new details are not available on a case without ‘tuning’ into a person during such
appointment times.