Acupuncture Release FormAcupuncture Release FormI hereby authorize Healing Arts Animal Care to perform acupuncture on my pet.* YesI have read the sheet/web page entitled “Veterinary Acupuncture” and understand the procedures, benefits, risks and possible side effects.* Yeshttp://healingartsanimalcare.com/acupuncture-2/This authorization serves for today and further treatments unless revoked in writing.* YesI certify that I have not been made any medical promise of success or guarantee of outcome of service. I understand that every medical condition is different and outcomes are based upon multiple factors.* YesI have fully read this consent information and understand its contents, implications and purpose.* YesI give permission for photos/videos of my pet and their health story to be used for social media, speaking engagements, and promotional materials for Healing Arts Animal Care.* Yes NoI understand and agree that all payments are due when services are rendered.* YesSignature*EmailThis field is for validation purposes and should be left unchanged.