Acupuncture treatment. Acupuncture attempts to normalize physiological functions, to modify the perception of pain, and to treat certain diseases and dysfunctions of the body. I have been informed that acupuncture is a safe method of treatment, but it may have side effects, including bruising, numbness or tingling near the needling sites that may last a few days and dizziness or fainting. I understand that I should not move while the needles are being inserted, during treatment, or when the needles are being removed. Unusual risks of acupuncture include lung puncture (pneumothorax) if acupuncture is performed in the region of the lung. Infection is another possible risk, although the acupuncturist below uses sterile disposable needles and maintains a clean safe environment. I understand that while this document describes the major risks of treatment, other side effects and risks may occur. I will notify the doctor who is caring for me if I am or become pregnant. Although acupuncture is safe to use during pregnancy, there are some acupuncture points to be avoided in pregnancy. I will also notify the doctor if I have a bleeding disorder, if I am taking anti- coagulants or other medication. DO NOT SIGN UNTIL YOU HAVE READ AND UNDERSTAND THE ABOVE. I have read, or have had read to me, the above explanation. By signing below I state that I have weighed the risks involved in undergoing treatment and have decided that it is in my best interest to undergo the treatment recommended realizing that no guarantees can be made regarding the outcome of treatment. Having been informed of the risks, I hereby give my consent to treatment. I intend this consent form to cover the entire course of treatment for my present condition and for any future conditions for which I seek treatment. Patient’s Name Date Patient’s Signature (or Parent/Guardian) Print name of Parent or Guardian (if a minor) NOTICE OF PRIVACY PRACTICES—ACKNOWLEDGEMENT & CONSENT TO USE AND DISCLOSE PROTECTED HEALTH INFORMATION Use and Disclosure of your Protected Health Information Your Protected Health Information will be used by Gerhardson Chiropractic or may be disclosed to others for the purposes of treatment, obtaining payment, or supporting the day-to-day health care operations of this office.
Acupuncture treatment. Upon approval from Dansk Sundhedssikring´s doctor, acupuncture for musculoskeletal disorders is covered. The insured can decide between either an acupuncturist from Dansk Sundhedssikring´s quality controlled network or an acupuncturist of their choosing. If the insured is a member of Sygeforsikringen Danmark then Dansk Sundhedssikring will settle any possible subsidies with them directly. If the insured chooses an acupuncturist from outside Dansk Sundhedssikring´s network then they may receive up to 10 treatments per calendar year as long as the treatments are pre-approved by Dansk Sundhedssikring´s doctor. If the insured also has work-related coverage then then the number of treatments for the work-related and leisure-related insurances combined are 10 per calendar year. If the insured chooses an acupuncturist from Dansk Sundhedssikring network there is no pre-defined number of treatments per calendar year. The reflexologist must be a registered RAB (Registered Alternative Practitioner)
Acupuncture treatment. 9. Physical or occupational therapy primarily for maintenance care.
