• Acupuncture Informed Consent Form

  • Before undergoing an acupuncture session, it is important that you know and understand some general information including the risks and benefits of acupuncture.

  • 1

    WHAT IS ACUPUNCTURE

    Acupuncture is a traditional Chinese medicine technique for balancing the flow of energy life force of the body - called 'chi' or 'qi' energy. This is practiced with the use of needles inserted through a person's skin at specific points of the body called acupuncture points. There are various disorders treated with the use of acupuncture. There is also increased use of this method for treating pain and relief from discomfort.

    Other treatments may include acupressure, cupping, electric or magnetic stimulation, or moxibustion.

  • 2

    THE ACUPUNCTURE PROCEDURE

    The patient shall lie down on a padded table for the treatment. For the insertion of the needles, it shall be inserted through the skin in various depths, depending on the strategic points. These needles are very thin so the patient will not feel pain, but only some mild discomfort. Once it reaches the correct path, the patient might feel some mild aching sensation. The acupuncturist may swirl the needles after placement or apply heat or electrical pulses. The needles will remain in place for around 10 to 20 minutes.

  • 3

    RISKS IN THE PROCEDURE

    One may experience soreness or minor bleeding, numbness, tingling, or bruising on the parts where the needles were inserted. We use single-use, disposable needles in our practice so rest assured, risk of infection is down to the lowest minimal if none at all.

    There are cases where nausea or drowsiness can occur; this is a good sign of the effects of the procedure. However, if symptoms worsen or continue after 2 days, please notify your acupuncturist. With this, we also do not advise driving after a procedure if you are affected.

    We do not prefer conducting the procedure with pregnant women as there are certain acupuncture points that may induce labor which may result in premature delivery or miscarriage.

  • 4

    BENEFITS

    Acupuncture has been used effectively for hundreds of years for a variety of diseases. This has also been used for relieving stress, back and joint pains, headaches, eyestrain, it may improve your immune system, relief from allergy, among others.  However, we cannot provide a guarantee for the outcome of any course of the treatment.

  • 5

    ACUPUNCTURE RESTRICTIONS

    The risk of complications may happen if one already has a pacemaker. Not everyone is a good candidate for acupuncture. If you have a bleeding disorder or taking some blood thinners, you might have chances of bleeding or bruising. Please check with us and your physician before undergoing acupuncture.

    If one has a pacemaker, acupuncture that involves applying mild electrical pulses may not be a suitable method as it may interfere with the pacemaker's operation.

    If one is pregnant, certain types of acupuncture may not be suitable given it may stimulate labor and could result in premature delivery. Please notify us if you are pregnant before undergoing the procedure.

  • 6

    HOW DO I PREPARE

    Other methods ask you to take tea orally. Teas may sometimes have an unpleasant smell or taste but rest assured they are not bad for you. In case you feel unusual effects happening after consumption, please let us know right away.

  • CONSENT STATEMENT

    I have read and understood the information provided above. I understand the possible risks of the treatment and its benefits. I have had the opportunity to inquire about details and these were answered to my satisfaction.

    I understand that my records may be reviewed by the administration and staff of the clinic, and I understand that these records will remain confidential within the said clinic and will only be released with my written consent.

    By signing below, I voluntarily express my consent to the treatment.

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