• Acupuncture Informed Consent Form

  • 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. My training was completed with Expectancy in London and Breeze Academy in Belfast

  • 2 THE ACUPUNCTURE PROCEDURE You 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 you should not feel pain, but there may be some mild discomfort. Once it reaches the correct path, you might feel some mild aching sensation. The needles will remain in place for around 40 to 50 minutes depending on reaction and response.

  • 3 RISKS IN THE PROCEDURE You may experience soreness or minor bleeding, numbness, tingling, or bruising on the parts where the needles were inserted. Very rarely a needle may stick, bend or break following insertion. I use single-use, sterile disposable needles in my practice. 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 me. With this, I also do not advise driving after a procedure if you are affected. I will ensure you are OK before you leave my practice. 

  • 4 BENEFITS Acupuncture has been used effectively for hundreds of years for a variety of conditions. 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.It can be used during pregnancy for relief of symptoms and birth preparation. However I cannot provide a guarantee for the outcome of any course of the treatment.

  • 5 ACUPUNCTURE RESTRICTIONS The risk of complications increase if you already have a pacemaker. Auricular(Ear)acupuncture should not be used if you have a history of rheumatic fever or heart valve issues. Not everyone is a good candidate for acupuncture. If you have a bleeding disorder or taking some blood thinners, you might have a risk of bleeding or bruising. Please check with me before undergoing acupuncture. 

  • 6 HOW DO I PREPARE Wear loose clothing so I can access easily various parts of you to insert needles ie your back, legs, shoulders. Drink water to remain hydrated before and after your session.

  • CONSENT STATEMENT I have read and understood the information provided above. I understand the possible risks of the treatment and its benefits. I understand that my records will remain confidential within the 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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