Consent Forms

Resources: Consent forms

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Welcome to our acupuncture community. When arriving at our clinic you will be asked to sign our consent forms and to agree to our clinic guidelines which are listed below.

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General Guidelines

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Here at East Village Acupuncture & Massage, we offer truly effective treatments in a room, with several treatments occurring at the same time. This allows us to offer high quality acupuncture at a price that is low enough to allow our patients to come in regularly and frequently. Our goal here is to help you get better and stay better! 

 

• Talking is kept at a minimum. We may ask you specific questions about the symptoms you are experiencing, but in general an attempt is made to keep voices down.

 

• Cell phones must be turned off before entering the community room. 

 

• Privacy is attempted, but cannot be guaranteed. Again, voices are kept low, and talking is at a minimum. However, because we treat in a large open space, it is simply not realistic for us to guarantee your privacy.

 

• We are in network with BCBS and Cigna- if you would like your insurance benefits checked so see if acupuncture is covered for you please fill out a benefits check form. 

 

• Punctuality is extremely important! For Massage: if you are late your massage will be cut short because there is a person scheduled right after you. For Acupuncture: Even though your appointment lasts for 45 minutes you are booking 15 minutes with an acupuncturist who is seeing a new patient every 15 minutes.  If you are late for your appointment we cannot guarantee that we will be able to see you and you will be charged for the appointment.  

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• Please note that we have a 24-hour cancellation policy.  If you must cancel your appointment with less than 24 hours notice you will be charged the full amount of the session.

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COVID-19 Guidelines

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Things are a bit different for our reopening. To help guide you through, here is a summary of what you can expect at our clinic.

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• When arriving for your appointment, please arrive at the exact time so you can be taken back to the treatment room right away. 

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• Patients will have their temperatures taken and answer screening questions before entering the treatment room.

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• We ask that patients who develop any COVID-19 symptoms, have been close to someone who has tested positive, or have not been social distancing please cancel their appointment. We are able to treat you remotely with herbal remedies if you are experiencing symptoms. Cancellation fees will not apply to patients cancelling last minute due to COVID-19 symptoms.

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• All patients, practitioners and staff must wear masks at all times.​

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• In our efforts to social distance and keep the clinic sanitized, we have only 3 massage tables in the treatment room that are separated by 6 feet of space and curtains. We are using the massage room for private acupuncture.

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• Sitting in the reception room is no longer permitted. Our reception team is only working part time so please do your best to book online, if you call in the evening your message may not be returned until noon the following day.

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• All sessions need to be paid for at the time of booking, we are requesting patients to keep a payment method on their account so that we can check them out remotely when needed.

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• We've added 4 HEPA filters to ensure continuous clean air flow.

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• We are not able to offer Massage at this time.

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