The Physiotherapy Clinics

Shockwave Consent Form

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Shockwave therapy (also known as Extracorporeal Shockwave Therapy, or ESWT) is a non-invasive treatment that uses acoustic waves to treat various musculoskeletal conditions. The therapy is primarily used to treat chronic pain, promote healing in conditions like tendinitis, plantar fasciitis, and calcific shoulder tendinitis. Before undergoing this treatment, it is important that you fully understand the procedure, its potential benefits, and any associated risks or contraindications. Please read the following information carefully and feel free to ask any questions before signing the consent form.

Procedure:

During the treatment, shockwaves will be delivered to the affected area using a specialised device. The treatment typically lasts between 5 to 15 minutes depending on the condition being treated and the severity of the problem. Multiple sessions may be required depending on your condition and response to therapy.

Potential Benefits

Tissue Regeneration
Acceleration of healing processes
Improve blood flow
Relief from chronic pain
Improved mobility and function

Contraindictions: Please inform your physiotherapist if any of the following conditions apply to you:

Potential Risks and Side Effects:

While shockwave therapy is generally safe, there are some potential risks, which include:

Temporary pain or discomfort at the treatment site
Bruising or swelling
Redness or skin irritation
Numbness or tingling in the treated area

Consent to Treatment:

I understand that shockwave therapy is an elective treatment, and I have been informed about the procedure, its benefits, potential risks, and contraindications. I confirm that none of the contraindications listed above apply to me or that I have discussed any concerns with my healthcare provider.

I acknowledge that I can withdraw my consent at any time and choose to stop the treatment. I understand that while shockwave therapy is generally considered safe, results may vary, and no guarantees have been made regarding the outcome of the treatment.

I will inform the clinic if I develop any new medical conditions or concerns before or during the course of your shockwave therapy

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