Informed Consent

Nick Buddle is an Acupuncturist, or Acupuncture and Eastern Medicine Practitioner (AEMP), in the State of Washington, holding license number AC60798039 since October 2017. He graduated with a Master of Science in Traditional Chinese Medicine from American College of Traditional Chinese Medicine (ACTCM) in San Francisco, CA in 2013 and completed the didactic portion of the Doctorate of Acupuncture and Oriental Medicine at ACTCM in 2016.

Jun Wu is an Acupuncturist, or AEMP, in the State of Washington, holding license number AC61132525 since March 2021. She graduated with a Master of Science in Traditional Oriental Medicine from the Midwest College of Oriental Medicine in Chicago, IL in 2015.

Anne Anderson is an Acupuncturist, or AEMP, in the State of Washington, holding license number AC60671308 since August 2016. She graduated with a Master of Science in Traditional Oriental Medicine from the Oregon College of Oriental Medicine (OCOM) in Portland, OR in 2015 and completed the didactic portion of the Doctorate of Acupuncture and Oriental Medicine at OCOM.

Acupuncture and Eastern Medicine is a health care service utilizing acupuncture or Eastern medicine diagnosis and treatment to promote health and treat organic or functional disorders, which includes a variety of traditional and modern acupuncture and Eastern medicine therapeutic treatments, such as the practice of acupuncture techniques and herbal medicine to maintain and promote wellness, prevent, manage, and reduce pain, and treat substance use disorder. Acupuncture and Eastern medicine includes the following:

• Acupuncture – the use of acupuncture needles or lancets to directly or indirectly stimulate acupuncture points and meridians;
• E-Stim – Use of electrical, mechanical, or magnetic devices to stimulate acupuncture points and meridians;
• Dry Needling – Intramuscular needling of trigger points and other nonspecific points throughout the body in accordance with acupuncture and Eastern medicine training;
• Auricular Acupuncture – All points and protocols for ear acupuncture including national acupuncture detoxification association (NADA) protocol, battlefield acupuncture, and the Nogier system;
• Non-Insertion Acupuncture – Use of contact needling and non-insertion tools such as teishin, enshin, or zanshin;
• Moxibustion – burning of dried Mugwort (moxa) over an acupuncture point or meridian;
• Acupressure – manual stimulation of acupuncture points and meridians;
• Cupping – cups made of glass or other materials are placed on the skin with a vacuum created by heat or other device;
• Dermal friction technique (gua sha) – use of a smooth object, often a ceramic spoon, to apply friction topically to the skin;
• Infrared – application of heat generated by an infrared lamp over a specific area of the body;
• Sonopuncture – stimulating acupuncture points or meridians through the use of sound or vibration;
• Laserpuncture – stimulating acupuncture points or meridians through the use of light;
• Point injection therapy (aquapuncture) – the subcutaneous, intramuscular, and intradermal injection of substances consistent with the practice of Eastern Medicine to stimulate acupuncture points, ah shi points, trigger points and meridians;
• Dietary advice and health education based on Eastern Medical theory, including the recommendation and sale of herbs, vitamins, minerals, and dietary and nutritional supplements. Herbs may be given in the form of pills, powders, tinctures, pastes, plasters, or other forms such as raw herbs to be cooked. Cooked herbs may be given to take internally or externally as a wash. Herbal formulas may include plant, shell, mineral, and animal materials. Health education does not include mental health counseling;
• Breathing, relaxation, and East Asian exercise techniques;
• Qi gong – a coordinated system of body postures, movement, breathing, and meditation;
• East Asian massage – manipulation of the soft tissues of the body for therapeutic purposes;
• Tui na – a method of Eastern Medicine bodywork, characterized by the kneading, pressing, rolling, shaking, and stretching of the body and does not include spinal manipulation; and
• Superficial heat and cold therapies.

Although acupuncture and the above procedures are extremely safe, there are potential risks and side-effects associated with treatment. These situations are rare and every precaution is taken to decrease the chance of occurrence. Acupuncture may cause discomfort, pain, bruising, and numbness, and/or tingling at or near the needling site, during or after the treatment. This may last for a few minutes or a few days or more. Infection, broken needle, needle sickness (including nausea, dizziness, and fainting), and aggravation of symptoms existing prior to the acupuncture treatment are also potential risks. Unusual risks of acupuncture include spontaneous miscarriage, nerve damage, and organ puncture, but these events are highly unlikely when performed by a skilled practitioner. Bruising is often a side effect of cupping. Burns and scarring are potential risks of moxa and cupping.

Some potential side effects of taking herbs include nausea, vomiting, gas, bloating, abdominal pain, changes in bowel movements, headaches, rashes, hives, and tingling of the tongue. Certain herbs should be avoided during pregnancy. The herbs prescribed are traditionally considered safe in the practice of Eastern Medicine, although some may be toxic in large doses. If any concerning symptoms or adverse reactions occur upon taking herbs, immediately discontinue taking the herbs and contact the practitioner. Any herbs prescribed need to be prepared and taken according to written and oral instructions given by the practitioner.

With this knowledge, I voluntarily consent to the above procedures, realizing that no guarantees have been given to me by Redmond Acupuncture regarding cure or improvement of my condition. I understand that this document describes the major risks of treatment but that other risks may exist and other side effects may occur. I do not expect the practitioner to be able to anticipate and explain all possible risks and complications of treatment and I wish to rely on my practitioner to exercise judgment that he thinks is in my best interest based upon the facts then known. I understand that I am free to withdraw my consent and to discontinue participation in any or all of these procedures at any time.

I agree to notify my practitioner if I have a bleeding disorder, I am taking blood-thinning medication, or have a pacemaker.

Women: I agree to notify my practitioner if I become pregnant or am planning to become pregnant.