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Facial Acupuncture Form and Consent docx

Facial Acupuncture Form and Consent docx 2025

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The document provides an informed consent form for facial acupuncture treatments, detailing the procedure, potential risks, benefits, and alternatives. It includes sections for patients to specify their skin type, concerns, current beauty routine, and any previous treatments or surgeries. The document emphasizes that facial acupuncture is not a surgical procedure but aims to improve skin appearance by addressing overall body health. It outlines possible complications such as bleeding, infection, and nerve injury while clarifying that results may vary and are not guaranteed.

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Click ‘Get Form’ to open the Facial Acupuncture Form and Consent document in the editor.
Begin by selecting your skin type from the options provided: Dry, Combination, Oily, or Normal. This helps your acupuncturist understand your skin's needs.
Next, check any skin concerns that apply to you. This section allows you to communicate specific issues like aging, acne, or hyperpigmentation.
In the 'Current Beauty Routine' section, list the products you use for cleansing, toning, moisturizing, and any treatments. This information is crucial for tailoring your facial acupuncture experience.
Proceed to answer questions regarding previous surgeries and facial treatments. Be honest about your history as it impacts treatment decisions.
Read through the Informed Consent section carefully. Initial each page to confirm understanding of risks and benefits associated with facial acupuncture.
Finally, sign and date the consent form at the end of the document to complete your submission.

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