Mandatory Disclosure
Many people have questions about this. In short, it's the law.
The Colorado
Acupuncture Practice Act, Section 12-29.5-103, C.R.S., Mandatory
disclosure of information to patients - retention of records of
disclosure, states: " (1) Every acupuncturist shall provide
the following information in writing to each patient during the
initial patient contact:
(a) The name, business address, and business phone number of the acupuncturist;
(b) A fee schedule;
(c) A statement indicating that:
(I) The patient is entitled to receive information….."
And so on. The complete list of requirements is in the application packet and is entitled "Mandatory Disclosure Check List." How you want your form to look is up to you, and you may want to add additional information such as the hours your clinic is open, possible side effects of acupuncture, your policy on canceled appointments, whether you accept insurance, and many other things. Then again, you may wish to put this information on a separate form and limit the Mandatory Disclosure Form to the items required by Colorado law.
Remember,
the format used here is only a suggestion. The information it contains,
however, MUST be included in your form!
- Download the sample Mandatory Disclosure Form
Adobe Acrobat Reader is required in order to view and print these materials. If you do not have Adobe Acrobat Reader, download the latest free version directly from the Adobe web site or convert a document to text.
.gif)