Consent form for Acupuncture

Acupuncture Consent Form
Patient Information and Consent Form

Please read this information carefully, and ask your practitioner if there is anything that you do not understand.

What is acupuncture?
Acupuncture is a form of therapy in which fine needles are inserted into specific points on the body.

Is acupuncture safe?
Acupuncture is generally very safe. Serious side effects are very rare – less than one per 10,000 treatments.

Does acupuncture have side effects?
You need to be aware that:

    drowsiness occurs after treatment in a small number of patients, and, if affected, you are advised not to drive;
    minor bleeding or bruising occurs after acupuncture in about 3% of treatments;
    pain during treatment occurs in about 1% of treatments;
    existing symptoms can get worse after treatment (less than 3% of patients). You should tell your acupuncturist about this, but it is usually a good sign;
    fainting can occur in certain patients, particularly at the first treatment.

In addition, if there are particular risks that apply in your case, your practitioner will discuss these with you.

Is there anything your practitioner needs to know?
Apart from the usual medical details, it is important that you let your practitioner know:

    if you have ever experienced a fit, faint or funny turn;
    if you have a pacemaker or any other electrical implants;
    if you have a bleeding disorder;
    if you are taking anti-coagulants or any other medication;
    if you have damaged heart valves or have any other particular risk of infection;
    if you are pregnant.

Single-use, sterile, disposable needles are used in the clinic.

Happy to proceed based on above? *