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 single-use, sterile, disposable needles are inserted into specific points on the body. Acupuncture is generally very safe. Serious side effects are very rare.
Other side effects:
drowsiness occurs after treatment in some patients. If affected, you are advised not to drive;
minor bleeding/bruising occurs in about 3% of treatments;
pain during treatment occurs in about 1% of treatments;
existing symptoms can get worse after treatment (< than 3% of patients). Tell your acupuncturist about this - it's usually a good sign;
fainting can occur in certain patients, particularly at the first treatment.
Is there anything your practitioner needs to know?
Apart from medical details, it is important to 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 anticoagulants or any other medication;
if you have damaged heart valves/have any particular risk of infection.
Statement of Consent: I confirm that I have read and understood the above information, and I consent to having acupuncture treatment. I understand that I can refuse treatment at any time. I understand that the practitioner will not be able to diagnose any health problems and will deliver complementary therapy based on the information I give. I understand that the treatments offered are not a substitute for medical advice and treatment. I understand that the practitioner can refuse to continue therapy at any time.
What is cupping?
Cupping is a therapy that applies negative pressure on the skin using glass, plastic, or silicone cups. The suction created by these cups stimulates and increases blood flow, which can help relieve joint and muscle pain, reduce inflammation, accelerate recovery, increase the function of the lymphatic and circulatory systems and increase overall relaxation and well-being.
Common Contraindications for Cupping Therapy
Blood clots
Bleeding disorders
Bruise easily
Haemophilia
Infections
Acute skin conditions
Burn / rash
Skin lesions
Cancer
Areas of herniation
Hematomas
Phlebitis / Varicose veins
Impaired sensation
Oedema / lymphedema
Certain medications
Deep vein thrombosis
Epilepsy
High blood pressure
Open wounds
Suspected haemorrhage
Diabetes with complications or an acute infection
Taking anticoagulant medication/blood thinners for example, Aspirin
Severe chronic disease such as heart disease
You are pregnant/are within 6 weeks of giving birth/are menstruating
Lymphedema or Anaemia
Recently given blood or undergone a medical procedure
Please Read Each Item Below
My therapist has informed me of the contraindications of cupping therapy, and I have provided my therapist with an accurate and complete medical history.
I have no contraindications for cupping therapy.
I agree to communicate to my therapist any physical discomfort experienced during the session.
I understand that the vacuum formed by cupping may result in marks being left on my body
I release the therapist from all liability for any harm that may unintentionally result from this treatment
I further understand that massage and cupping therapy is not a substitute for a medical examination or treatment, and that I should see a physician or other qualified health specialist for any mental or physical ailment of which I am aware. I understand that complementary therapists do not diagnose disease, and nothing said during the treatment should be construed as such. My consent is informed and voluntary and I understand that I may withdraw my consent at any time except for actions already taken
