Patient After-Visit Summary (Acupuncture)

Patient Name: [Patient name]

Date of Birth: [Date of birth]

Date of Visit: [Date of visit]

Provider: [Provider name and credentials]

Clinic Phone: [Clinic phone number]

Today's Summary & Next Steps

[1–2 sentence summary of what was treated today] (Use plain, patient-friendly language. Avoid medical jargon.)

• Drink [hydration guidance] (If not discussed, use "plenty of water today.")
• Rest [rest and activity guidance] (If not discussed, use "take it easy for the rest of today.")
• Practice [home technique name] [frequency] (Include only if taught today.)
• Schedule [next appointment date/time or timeframe to return]
• Monitor [key symptoms to watch] (Include only what was discussed.)

What We Did Today

(Omit this section if the visit was consultation only with no treatment performed.)

• Areas treated: [Body regions in plain terms]
• Needle time: [Approximate retention time in minutes]
• Adjunct therapies: [electroacupuncture / cupping / gua sha / moxibustion / ear seeds] (Include only therapies actually used.)
• Aftercare for adjuncts: [Relevant notes such as expected skin marks from cupping, when to remove ear seeds] (Include only if adjunct therapies were used.)

After Your Treatment

What you may notice (normal):

• Relaxation or mild fatigue for the rest of today
• Mild soreness or tenderness where needles were placed
• Small bruises that fade over a few days
• Brief lightheadedness when standing that improves with rest

(These effects usually resolve within 24–48 hours.)

Self-care for today:

• Avoid [alcohol / very hot baths / saunas / strenuous exercise] for [timeframe] (Include only items discussed or consistent with clinic practice.)
• Protect cupped or gua sha areas: keep clean and dry; color changes fade in a few days. (Include only if performed.)
• Avoid additional heat to moxibustion areas for [timeframe]. (Include only if performed.)
• Press ear seeds gently [times per day] and remove by [timeframe]. (Include only if ear seeds were placed.)
• Sit a moment before standing if you feel very relaxed or lightheaded.

Home Program

(Include this section only if specific techniques were taught today. Omit entirely if none were assigned.)

• [Technique name] — [Location in plain terms]
  • How: [Brief technique description]
  • Time/Reps: [Hold duration and repetitions]
  • Frequency: [Times per day or per week]
  • Stop if: you feel sharp pain, numbness, dizziness, or worsening symptoms.

(Repeat the above format for each additional point, stretch, or exercise assigned.)

When to Seek Help

Call 911 or go to the ER if you have:

• Trouble breathing or chest pain (especially if chest, upper back, or neck were treated today)
• Fainting that does not resolve quickly
• Signs of severe allergic reaction (face or lip swelling, difficulty breathing)

Contact our clinic the same day if you have:

• Fever, chills, or spreading redness/warmth/swelling at a needle site
• Persistent dizziness or worsening pain that does not improve with rest
• Any burn or blister after heat therapy

Contact us at your next opportunity for:

• Larger-than-expected bruising or questions about your aftercare

Call our clinic at: [Clinic phone number]

Follow-Up

• Next visit: [Date / time / location] (Include if already scheduled.)
• Plan: [Return in X–Y weeks / Contact us to schedule] (Include if not yet scheduled.)
• Track: [1–2 symptoms or goals to monitor before next visit] (Optional; include only if discussed.)

Clinic Contact: [Phone number] | [Office hours]

After-hours guidance: [After-hours instructions, or "For emergencies, call 911 or go to the nearest ER."]