Sending Patient Dry Needling Consent Form


Integrative Dry Needling involves placing a small needle into the tissue that is tender with the intent ot normalize the physiology of the area and regain homeostasis whick will improve the function of the musculoskeletal system resulting in symptom reduction.

Integrative Dry Needling is a valuable treatment for musculoskeletal pain. Like any treatment there are possible complications. While these complications are rare in occurence, they are real and must be considered prior to giving consent to treatment.

Risks of the Procedure

Though unlikely there are risks associated with this treatment. The most serious risk associated with Dry Needling is accidental puncture of a lung (pneumothorax). If this were to occur, it may likely only require a chest x-ray and no further treatment. The symptoms of shortness of breath may last several days to weeks. A more severe lung puncture can require hospitalization and re-inflation of the lung. This is a rare complication and in skilled hands should not be a concern.

Other risk may include bruising, infection and nerve injury. Please notify your provider if you have any conditions that can be transferred by blood. Bruising is a common occurence and should not be a concern unless you are taking a blood thinner. As the needles are very small and do not have a cutting edge, the likelihood of any significant tissue trauma from Dry Needling is unlikely.

Please consult with your practitioner if you have any questions regarding the treatment above

Do you have any known disease or infection that can be transmitted through bodily fluids?

If you marked YES, please discuss with your practitioner