Physiotherapy, Acupuncture & Massage
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Acupuncture Information & Consent Form

Please carefully read the information below, and submit your details 24 hours prior to your massage session. This makes your check-in faster, and helps us save trees! If you would prefer a fillable PDF version of the form please contact us. Alternatively a paper form will be available on the day.


What is acupuncture?

Acupuncture can reduce pain by stimulating the brain and spinal cord to produce natural pain-relieving chemicals such as endorphins, melatonin (which helps improve sleep) and serotonin (to promote well-being). These chemicals assist the body’s healing processes and offer pain relief. In traditional Chinese Medicine (TCM) it is believed that stimulating certain Acupuncture points on the body can help to restore the balance between Yin and Yang that become disturbed in illness.


Conventional acupuncture

This involves the use of single-use, pre-sterilised, disposable, fine needles that are inserted into specific points on the body. A number of needles may be used during each treatment, and these are typically left in position for about 20 minutes before being removed. Conditions treated by this method include osteoarthritis, back pain, neck pain, tennis elbow and foot pain.


Trigger point acupuncture

This may be used to aid relaxation in specific muscles following traumas, for longer-term unresolved muscle pain, or as a way of increasing muscle length in order to aid stretch and rehabilitation. The needle is inserted into the affected muscle until the tissue is felt to relax under the needle, which is then removed. This often produces an effect quite quickly.



This is a healing art in which the therapist use their hands to activate acupuncture or trigger points in order to relieve muscle tightness, or to stimulate Qi flow and balance the body. The amount of pressure used varies according to the condition and it is often used to treat people who are sensitive, people with a phobia of needles, children and the frail.



Cupping is a technique used to introduce warmth into the acupuncture points, or to areas that require increased stimulation of Qi flow. This gives the effect of increasing the circulation, removing waste products, and reducing muscle spasm and pain. Conditions treated with these techniques include osteoarthritis, areas of poor Qi flow and cold conditions.


Is acupuncture safe?

Acupuncture is generally safe, and serious side effects are very rare – less than 1 per 10,000 treatments.


What are the side effects of acupuncture?

  • Minor bleeding or bruising occurs after acupuncture in about 3% of treatments.
  • Drowsiness may occur in a small number of people, and if affected, you are advised not to drive.
  • Pain during treatment occurs in about 1% of treatments.
  • Symptoms can get worse after treatment (less than 3% of patients) but this is usually a good sign and should be discussed with your acupuncturist.
  • Fainting may occur in certain people, particularly at the first treatment session.
  • If you have any particular risk factors your acupuncturists will discuss these with you.

Acupuncture Consent

If you have any questions about the information above, or about the form please contact us before submitting the form.

Do you have a bleeding disorder?(required)

Are you taking anticoagulants (eg aspirin, warfarin) or any other medication?(required)

Do you have a pacemaker or any other electrical implants or joint replacements?(required)

Do you have damaged heart valves or any other particular risks to infection?(required)

Do you have an infection at present?(required)

Are you pregnant or trying to get pregnant?(required)

Do you have any allergy to metals?(required)

Have you got any other medical problems?(required)

Are you afraid of needles?(required)

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