Please review the Pre-Treatment Consent that will be signed prior to your first treatment 

Consent Form for Acupuncture Treatment 

I (signed) understand the hazards and potential dangers involved in treatment by means of acupuncture. I believe that this treatment is in my best interest and I understand that no guarantee of results has been made. I understand and accept the risks of treatment that the acupuncturist has explained to me with include, but are not limited to, bruising, bleeding, swelling, fainting, or infection. Minor bruising and bleeding are common and to be expected as the body responds to acupuncture treatment. Certain medications or social habits are known to lessen the potential results of acupuncture. These include alcohol, tobacco, steroids or narcotics. I agree to inform Dr. Clemensen of any use of these substances. I understand that it usually requires a series of acupuncture treatments to significantly change a condition and receive benefit. I attest at the time of treatment that I am not pregnant and I am aware that Dr. Clemensen does not provide acupuncture services during pregnancy. My signature indicates that I have read and fully understand the above information regarding the consent to this procedure. I have had the opportunity to ask questions about any matter which I did not understand, and I have received satisfactory explanations to my questions.