Informed Consent

Patient Notification of Qualifications and Scope of Practice


Sonoma Acupuncture employs Licensed Acupuncturists (L.Ac.) to provide medical services. The following information outlines the providers’ qualifications and scope of practice so that you, the patient, can engage in informed consent to treatment.

Notification of Qualifications

Nick Buddle is a Licensed Acupuncturist (L.Ac.) in the state of California, holding license number AC16066 since May 2014. He graduated with a Master of Science in Traditional Chinese Medicine from American College of Traditional Chinese Medicine (ACTCM) in San Francisco, CA in 2013 and completed the didactic portion of the Doctorate of Acupuncture and Oriental Medicine at ACTCM in 2016.

Scope of Practice

California Code, Business and Professions Code – BPC § 4937

An acupuncturist’s license authorizes the holder thereof:

(a) To engage in the practice of acupuncture.

(b) To perform or prescribe the use of Asian massage, acupressure, breathing techniques, exercise, heat, cold, magnets, nutrition, diet, herbs, plant, animal, and mineral products, and dietary supplements to promote, maintain, and restore health.  Nothing in this section prohibits any person who does not possess an acupuncturist’s license or another license as a healing arts practitioner from performing, or prescribing the use of any modality listed in this subdivision.

(c) For purposes of this section, a “magnet” means a mineral or metal that produces a magnetic field without the application of an electric current.

(d) For purposes of this section, “plant, animal, and mineral products” means naturally occurring substances of plant, animal, or mineral origin, except that it does not include synthetic compounds, controlled substances or dangerous drugs as defined in Sections 4021 and 4022 , or a controlled substance listed in Chapter 2 (commencing with Section 11053 ) of Division 10 of the Health and Safety Code.

(e) For purposes of this section, “dietary supplement” has the same meaning as defined in subsection (ff) of Section 321 of Title 21 of the United States Code , except that dietary supplement does not include controlled substances or dangerous drugs as defined in Section 4021 or 4022 , or a controlled substance listed in Chapter 2 (commencing with Section 11053 ) of Division 10 of the Health and Safety Code.


Although acupuncture and the above procedures are extremely safe, there are potential risks and side-effects associated with treatment. These situations are rare and every precaution is taken to decrease the chance of occurrence. Acupuncture may cause discomfort, pain, bruising, and numbness, and/or tingling at or near the needling site, during or after the treatment. This may last for a few minutes or a few days or more. Infection, broken needle, needle sickness (including nausea, dizziness, and fainting), and aggravation of symptoms existing prior to the acupuncture treatment are also potential risks. Unusual risks of acupuncture include spontaneous miscarriage, nerve damage, and organ puncture, but these events are highly unlikely when performed by a skilled practitioner. Bruising is often a side effect of cupping. Burns and scarring are potential risks of moxa and cupping.

Some potential side effects of taking herbs include nausea, vomiting, gas, bloating, abdominal pain, changes in bowel movements, headaches, rashes, hives, and tingling of the tongue. Certain herbs should be avoided during pregnancy. The herbs prescribed are traditionally considered safe in the practice of East Asian Medicine, although some may be toxic in large doses. If any concerning symptoms or adverse reactions occur upon taking herbs, immediately discontinue taking the herbs and contact the practitioner. Any herbs prescribed need to be prepared and taken according to written and oral instructions given by the practitioner.

Informed Consent to Treatment

With this knowledge, I voluntarily consent to the above procedures, realizing that no guarantees have been given to me by Sonoma Acupuncture regarding cure or improvement of my condition. I understand that this document describes the major risks of treatment but that other risks may exist and other side effects may occur. I do not expect the practitioner to be able to anticipate and explain all possible risks and complications of treatment and I wish to rely on my practitioner to exercise judgment that he thinks is in my best interest based upon the facts then known. I understand that I am free to withdraw my consent and to discontinue participation in any or all of these procedures at any time.

I agree to notify my practitioner if I have a bleeding disorder, I am taking blood-thinning medication, or have a pacemaker.

Women: I agree to notify my practitioner if I become pregnant or am planning to become pregnant.

*** Please note that your signature for consent to and understanding of the aforementioned information will be recorded as an e-signature in our Electronic Health Record system as a part of the New Patient Intake form. If you have any questions please call the clinic at (707) 921-9661 or send us an email at ***