Forms

 Acupuncture Informed Consent to Treat

  • Consent to the performance of acupuncture treatments and other procedures within the scope of the practice of acupuncture.

Client Responsibility

  • Acupuncture is a system of medicine based on Traditional Oriental principles and is not meant to replace western medicinal treatment should the case warrant it.


HIPAA Patient Consent

  • Insures the patient understands that the medical facility cannot share health information with another party without permission.


Symptoms Checklist

  • Checklist to inform the acupuncturist of the patients medical history.