Acupuncture Consent Form

Acupuncture health care seeks to restore health through natural means without the use of medicine or surgery. This gives the body maximum opportunity to utilize its inherent recuperative powers. The success of the acupuncture doctor’s procedures often depends on the environment, underlying causes, physical and spinal conditions. It is important to understand what to expect from acupuncture health care service.

I have had an opportunity to discuss with Dr. Scearce the nature and purpose of acupuncture adjustments and procedures. I understand and I am informed that, as is with all healthcare treatments, results are not guaranteed and there is no promise to cure. I further understand and I am informed that, as is with all healthcare treatments, in the practice of acupuncture there are some risks to treatment, including, but not limited to, muscle spasms for short periods of time, aggravating and/or temporary increase in symptoms, lack in improvement of symptoms, fractures, disc injuries, strokes, dislocations and sprains. I do not expect the doctor to be able to anticipate and explain all risks and complications, and I wish to rely on the doctor to exercise judgment during the course of the procedure which the doctor feels at the time, based upon the facts then known, is in my best interests.

I further understand that acupuncture adjustments and supportive treatment is designed to reduce and/or correct pain allowing the animal's body to return to improved health. It can also alleviate certain symptoms through a conservative approach with hopes to avoid more invasive procedures. However, like all other health modalities, results are not guaranteed and there is no promise to cure.

I certify that my animal(s) have been referred for acupuncture care to Dr. Scearce by my veterinarian and that my animal(s) have been continuing to receive concurrent care from my veterinarian.