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East-West Wellness Consent to Treatment Form By signing below, I do hereby voluntarily consent to be treated with acupuncture and/or substances from the Oriental Material Media by a licensed acupuncturist
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How to fill out east-west wellness consent to:

01
Start by carefully reading the consent form to ensure you understand all the information and requirements.
02
Fill in your personal details such as your name, address, contact information, and date of birth in the designated areas.
03
Provide information about your current health condition, including any pre-existing medical conditions or allergies that may be relevant to the treatment or therapies offered by East-West Wellness.
04
Indicate any medications you are currently taking, including prescription drugs, over-the-counter medications, or supplements.
05
Read and understand the potential risks and benefits associated with the treatments or therapies you will be receiving at East-West Wellness.
06
Sign and date the consent form to indicate that you have read and understood all the information provided, and that you willingly give your consent for the treatments or therapies to be performed.
07
If applicable, provide any additional information requested on the consent form, such as emergency contact details or insurance information.

Who needs east-west wellness consent to:

01
Individuals who wish to receive treatments or therapies at East-West Wellness must complete and sign the consent form.
02
This includes both new and existing clients who may be undergoing different types of wellness treatments such as acupuncture, herbal medicine, massage therapy, or nutritional counseling.
03
Consent forms help ensure that individuals are aware of the potential risks, benefits, and responsibilities associated with the services provided by East-West Wellness, and that they have given their informed consent to receive these treatments.
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East-West Wellness consent refers to the agreement of a participant to participate in the wellness program offered by East-West Wellness.
Participants who wish to join the wellness program at East-West Wellness are required to file the consent form.
Fill out the consent form with your personal information and signature to indicate agreement to participate in the program.
The purpose of East-West Wellness consent is to ensure participants understand the program requirements and agree to abide by them.
The consent form may require personal information such as name, contact information, and signature to participate in the program.
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