Mark Pillans

    Patient forms

    Treatment consent forms:

    PDF files

    Consent form – adult herbal medicine treatmentDownload
    Consent form – child herbal treatmentDownload

    Privacy/ GDPR consent forms:

    PDF files

    Consent form – privacy- GDPRDownload
    Consent form – Heidi (+ explainer)Download

    Health questionnaire:

    PDF version

    Intake form – health questionnaireDownload

    Word document version

    Intake form – health questionnaireDownload

    If you intend to email me sensitive data, I recommend you consider setting up a Protonmail email account (free via https://protonmail.com), which will keep your information securely encrypted and only accessible between ourselves. My email – but not the contact form via this site – runs through Protonmail. You can email me from any email system, but non-Protonmail accounts will not be encrypted.

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