Acupuncture consent form

An Acupuncture consent form is a document patients review and sign before receiving acupuncture.

It records relevant health information, explains the proposed treatment and possible risks, and documents the patient's informed consent to proceed.

An Acupuncture consent form may include patient details, medical history, medications, allergies, pregnancy information, bleeding conditions, previous acupuncture treatments, proposed treatment, possible benefits, risks and side effects, alternatives, and a signature.

The content should reflect the treatments actually provided by the practitioner.

Possible effects may include temporary soreness, minor bleeding, bruising, numbness or tingling near a needle site, dizziness, or fainting.

Rare but serious complications associated with improperly performed acupuncture can include infection, punctured organs, and injury to the central nervous system.

Yes. The form can ask patients about prescription medicines, over-the-counter medications, supplements, and other treatments relevant to their care. Information about medications may be particularly relevant when assessing bleeding risk or other health considerations before needling.

Yes. Pregnancy can be relevant to treatment planning, and some acupuncture practices or techniques may need to be modified or avoided depending on the patient's circumstances.

NCCIH notes that people who are pregnant may need to modify or avoid some complementary health practices, so relevant health information should be discussed with the practitioner.

Yes. If the practitioner offers cupping, moxibustion, electroacupuncture, tui na, or other techniques alongside acupuncture, these can be identified in the consent form.

The potential effects and risks associated with each additional treatment should be described separately where appropriate.

Practices may collect comprehensive informed consent before the initial course of treatment and review relevant information at future appointments.

A new or updated consent form may be appropriate when the patient's health or medications change, a substantially different treatment is proposed, or the practice updates its consent terms.

Answer...

An electronically signed Acupuncture consent form may help document informed consent when the treatment information is clearly presented, the patient actively agrees, and a reliable signed record is retained.

Consent and electronic-signature requirements vary by jurisdiction and professional licensing rules, so acupuncture practices should customise the form and consent process for their local requirements.