Informed Consent to Treatment

1. Practitioner Information

  • Name: Sebastian Ardenz

  • Clinic: Nexus Health

  • Address: [Your Clinic Address in NZ]

  • Qualifications:

    • Bachelor of Health Science in Acupuncture

    • Registered Acupuncturist (CMCNZ)

    • Diploma in Tui Na

    • Actif First Aid Certificate

2. Nature of Your Treatment 

The treatment you will receive is based on a comprehensive assessment and is tailored to your specific needs. It may include, but is not limited to, the following techniques:

  • Acupuncture 

  • Tui Na (Chinese Therapeutic Massage) 

  • Cupping Therapy 

  • Gua Sha 

  • Moxibustion 

  • Electro-stimulation

For more detailed information on the nature of each modality, please refer to the Service Descriptions on our website at [Your Nexus Health Website Address] or ask your practitioner.

3. Potential Benefits & Risks of Treatment

  • Potential Benefits: The goal of treatment is to improve your health and wellbeing. Potential benefits include, but are not limited to:

    • Pain reduction or management.

    • Improved physical function and mobility.

    • Stress and anxiety relief.

    • Enhanced overall wellbeing.

  • Potential Risks: While all our therapies are considered safe when administered by a qualified practitioner, there are some potential risks and side effects, most of which are minor and temporary. These include:

    • Minor pain, discomfort, or aching at the needle insertion sites.

    • Minor bleeding or bruising at the treatment site.

    • Temporary marks on the skin from Cupping or Gua Sha, which are a normal treatment response and typically fade within several days.

    • Drowsiness, relaxation, or light-headedness following treatment.

    • A temporary, short-term worsening of symptoms as the body's healing process is stimulated.

    • Allergic reaction to massage oils or the smoke from moxibustion.

    • Very Rare Risks: While extremely uncommon, more serious risks include infection and pneumothorax (collapsed lung) from needling. We adhere to strict hygiene protocols, using single-use, sterile needles for every treatment to minimise these risks.

4. Alternative Treatment Options 

You have the right to choose your course of care. Alternatives to the treatments offered at Nexus Health may include:

  • Care from your General Practitioner (GP) or other medical specialists.

  • Prescription or over-the-counter medications.

  • Physiotherapy, Osteopathy, or Chiropractic care.

  • Lifestyle modifications (e.g., exercise, diet).

  • Cognitive-behavioural therapies or counselling.

5. Confidentiality and Privacy 

All the information you provide to your practitioner is confidential and handled in strict accordance with our Privacy Policy, the Privacy Act 2020, and the Health Information Privacy Code 2020. Your information will not be disclosed to any third party without your express written consent, unless required by law or to process an ACC claim on your behalf.

6. Consent Declaration

  • I hereby declare that I have read and understood the information provided on this form.

  • I have had the opportunity to ask questions about the nature of my treatment, the potential benefits and risks, and alternative options, and I have received satisfactory answers.

  • I understand that I have the right to refuse or withdraw from treatment at any time.

  • I voluntarily consent to receive the treatment proposed by my practitioner at Nexus Health.

  • I acknowledge my financial obligations for the treatment provided and confirm I have been made aware of the 24-hour appointment cancellation policy. I understand that if I fail to provide 24 hours' notice for a cancellation, I may be charged the full price of the treatment.