Consent Form

I understand that I am the primary decision maker for my pet’s health care. As part of this role, I have been informed about the treatments recommended by Mindful Paw Holistic Care, including their benefits, risks, and alternatives. This informed consent is intended to help me make knowledgeable choices regarding my pet’s care. I request and consent to the administration of acupuncture and other holistic treatments for my pet. These treatments may include acupuncture, moxibustion, electrostimulation, laser therapy, Chinese herbal medicine, energy healing, homeopathy, essential oils, and nutritional counseling. I understand the following:

• Acupuncture is generally considered safe, but potential side effects include bruising, tingling, dizziness, fainting, burns, scarring, infection, nerve damage, or organ puncture.

• Herbs and supplements recommended may carry risks such as nausea, vomiting, diarrhea, rashes, hives, or in rare cases, liver or kidney damage. I will notify the staff if my pet is or becomes pregnant or is nursing.

• Results are not guaranteed, and no cures are promised.

I agree to inform the clinic of any medical history, medications, or supplements my pet is currently taking. I understand that records may be reviewed and will be kept confidential. I am aware that there are other treatment options available and I retain the right to seek a second opinion.

I also authorize Mindful Paw Holistic Care to perform blood work and prescribe medication for my pet, and I understand that there may be possible side effects associated with these treatments.

By signing below, I confirm that I have read and understand this consent form, have had the opportunity to ask questions, and agree to the recommended care.