ACKNOWLEDGEMENT & UNDERTAKING

Standard of Practice for Prescribing

This Acknowledgement & Undertaking relates to a decision to relinquish the Standard of Practice for Prescribing. It is a legally binding document between the undersigned Registrant of the College and the College of Naturopaths of Ontario.

I, the undersigned, hereby acknowledge and undertake as follows:

1. Status of Registration

I am currently a Registrant of the College, registered in the General class.

2. Standard of Practice for Prescribing

I have met the Standard of Practice for Prescribing as set out in section 9(5) of the General Regulation made under the Naturopathy Act, 2007.

3. Relinquishing the Standard

I have advised the College that, as of the date set out on my Application to Relinquish the Standard of Practice for Prescribing, I have ceased or will cease any activity in my practice relating to the Standard of Practice for Prescribing.

4. Outcome of Relinquishment

I understand and acknowledge that relinquishing the Standard of Practice for Prescribing means that I cannot perform, delegate, or accept delegation of the following controlled acts authorized to the profession, as set out in section 4 of the Naturopathy Act, 2007:


a.    administering a substance by inhalation or injection,

b.    prescribing, dispensing, compounding or selling a drug designated in regulations.

5. Naturopathic Doctor Register Notice

I acknowledge that as a result of my decision, the following information will be posted on the College’s Naturopathic Doctor Register on the Effective Date as follows:


As of “Effective Date”, the Registrant is not authorized to prescribe, dispense, compound or sell a drug, or administer a substance by inhalation or injection.

6. Resumption of Performing the Controlled Acts

I acknowledge that I must successfully complete a course that includes relevant training in therapeutic prescribing, approved by Council, and an examination in therapeutic prescribing approved or administered by the College, prior to resuming the controlled acts noted in paragraph 4 of this Acknowledgment and Undertaking.

7. With Full Understanding

I fully understand the terms of this Acknowledgment and Undertaking.

8. Entered into Voluntarily

I am signing the Acknowledgment and Undertaking voluntarily, and without compulsion or duress.

9. Breach of Agreement

A breach in any of the terms of this Acknowledgment and Undertaking may constitute professional misconduct on my part for which the College may take action against me and this document is admissible in any such proceeding

10. Legal Advice

I have been strongly advised by the College to obtain independent legal advice prior to signing this Acknowledgment and Undertaking and that I have either done so or I have had an adequate opportunity to do so.

Please enter your full and proper name as it appears on the public register using the format Dr. Jane Doe, ND.

Signature


By checking the box below, I am hereby affixing my digital signature to this Agreement & Undertaking indicating that that I have read and agreed to all of the provisions set out herein and that this Agreement is bound directly to me.


If for any reason you cannot affix your digital signature, please contact the Registration Team at registration@collegeofnaturopaths.on.ca to discuss your questions or concerns.


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