Client Consent for Acudetox Treatment

Treatment Description

Acudetox is performed by placing thin, sterilized needles onto the surface of the ear. The treatment takes approximately 30–45 minutes and is usually done in a group setting. Treatments are provided by an Acudetox Specialist (ADS) or a professional acupuncture practitioner or supervised trainee.

Possible Benefits of Treatment

The use of Acudetox for detoxification, recovery support, and relapse prevention has been shown to help relieve acute symptoms of withdrawal from various substances. Individuals often experience immediate relief and a decrease in tension and anxiety. Further treatment may reduce such withdrawal symptoms as profuse sweating, headache, body ache, stomach pain, runny nose, drug dreams, and cravings. Participants may also develop a greater sense of calm and connection with themselves.

Voluntary Participation

I hereby voluntarily consent to be treated with Acudetox. I understand that I will be treated with acupuncture needles.

I acknowledge that I have not been guaranteed any specific outcomes concerning the uses and effects of Acudetox. I understand that I am free to discontinue Acudetox treatment at any time.

Though Extremely Rare, Possible Side Effects and Healing Reactions

I understand that Acudetox may result in certain side effects, including local bruising, slight bleeding, fainting, temporary pain or discomfort, and temporary aggravation of symptoms existing prior to treatment. Conventional medical therapy may also be indicated, either in response to an emergency or as deemed necessary at the discretion of a licensed health care practitioner.

Medical Referral

I understand that if there is a worsening of an ailment or condition, or if a new ailment or condition arises, I should consult a licensed physician. I also understand that if I am currently under a physician’s care, I should continue as long as my physician and I deem it necessary. This mobile program does not recommend altering medications or other therapies without first consulting my personal physician or health care provider.

Infectious Disease and Clean Needle Procedures

I understand that there are infectious diseases which have the potential to be carried through the air, through physical contact, and through body fluids. I understand that ADSes and acupuncture practitioners follow universally prescribed precautions to guard against the spread of infection.

In the case of blood-borne infections such as hepatitis or HIV, I understand that the Acudetox providers of this mobile program follow strict precautions and use only sterilized, prepackaged, disposable needles. The acupuncture needles used for this treatment are single-use and applied according to nationally recognized professional standards.

I further understand that I am responsible for cleaning my ears with sterile alcohol pads or other skin-cleansing agents prior to Acudetox treatment, and that this mobile program will provide these supplies.

Acknowledgment and No Refund Policy

I acknowledge that I have read and fully understand the information provided above regarding Acudetox treatment through Twin Peaks Wellness. I have the opportunity to ask questions of Twin Peaks Wellness via email prior to my session.

I understand that all services provided by Twin Peaks Wellness are final and non-refundable. No refunds will be given for any reason, including dissatisfaction with results or side effects experienced.