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Questionnaire
Firstly, do you have a medical condition that has been causing you distress for 3+ months?
(Required)
TGA guidelines state you must have a medical condition for 3+ months to qualify for alternative medicine. Some examples include chronic pain, anxiety, depression, insomnia, migraine.
Yes
No
Great, and how have you tried treating your condition?
(Required)
Under TGA guidelines you must have tried other treatments before you can be considered for alternative medicine.
Alternative medication
Natural/alternative therapies e.g. physiotherapy, psychological therapy, meditation
I have not treated because I dislike alternative medication, and haven't considered other therapies
I have not treated my condition
Now a little more about your treatment. During your treatment, were you...
(Required)
Unsuccessful in fully treating your condition
Experiencing unwanted side effects
Self-treating through non-prescribed alternative medicine
Able to treat your condition fully without alternative medicine
And to check, are you pregnant?
(Required)
Yes
No
Finally, do you have a history of psychosis?
(Required)
Psychosis - a severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality.
Yes
No
Email
(Required)
Thank you, just one last thing! Please share your email address and we'll share your results.
Consent
(Required)
Privacy Notice
The information you are providing to JWY Services Pty Ltd (T/A Joy Leaf) (ABN 29 638 678 092) may include personal information under the Privacy Act 1988 (Cth). We collect, hold, use and disclose personal information you provide to us in the manner set out in our Privacy Policy. We use your personal information to provide medical care and services that you request, and to keep you informed about products and services that may be of interest to you. We may disclose your personal information to third parties, to enable us to provide you with products and services that you request and as required by law. If you do not provide the personal information requested, we may not be able to provide you with our products or services. Our Privacy Collection Notice contains information about how you may request access to or correction of your personal information. Our Privacy Policy also contains information about how you may complain about a breach of the Australian Privacy Principles and how we will deal with such a complaint. Your personal information may be accessed from, transferred to, and/or stored outside Australia by our service providers. The data protection laws in that country may be of a lower standard than those in Australia. We will, in all circumstances, safeguard the personal information as set out our Privacy Collection Notice.
I consent to the collection, storage and use of my personal information in accordance with the Privacy Collection Notice. I understand that I can withdraw my consent at any time.*
