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GP & Medical Healthcare Provider Communication Consent

Practice Information

Practice Name: Get Nutrihelp
Practitioner: Kath Nagle (Nutritional Therapy Practitioner & Kinesiologist)

Purpose of Consent

At Get Nutrihelp, nutritional therapy and kinesiology are offered as complementary modalities alongside standard healthcare. While direct contact with your medical provider is not routine for every session, there are instances where sharing information with your General Practitioner (GP) or specialist is beneficial for your safety, care coordination, or in the event of health concerns.

Under UK GDPR and clinical confidentiality standards, your explicit permission is required before any health information or session summary can be shared with your GP or medical team.

Client Full Name

Date of Birth

Phone

GP Name / Surgery Name

GP Surgery Address / Town

GP Surgery Phone Number

Consent Options

Option A: Explicit Consent GrantedI GIVE PERMISSION for Kath Nagle (Get Nutrihelp) to communicate relevant health background, nutritional protocols, or session notes to my GP or medical specialist when necessary for care coordination, safety, or professional referral.

Option B: Consent Withheld / DeclinedI DO NOT GIVE PERMISSION for Get Nutrihelp to contact or share information with my GP or medical team. I understand that I remain fully responsible for managing my medical care and informing my doctor of any complementary health approaches I undertake.

Emergency / Safety Exception

Please note: In exceptional circumstances where there is an immediate, serious risk to life or safety, or where required by law under statutory safeguarding duties, confidentiality may be breached to contact emergency services or medical professionals regardless of the option selected above.

Client Declaration & Signature

I understand that I may withdraw or modify this consent at any time by providing written notice to Get Nutrihelp.
I confirm that the information provided above is accurate.

Client Signature

Sign here