Patient Notification of Qualifications and Scope of Practice

In accordance with RCW 18.06.130 and WAC 246-803-300

Qualifications for all of our practitioners include the following education and license information:

Stephanie Gianarelli

  • Bachelor of Arts in International Studies- University of Washington- Seattle, WA  
  • Masters of Science in Acupuncture and Oriental Medicine- SW Acupuncture College- Santa Fe, NM  - June 1999
  • Washington State License - East Asian Medicine Practitioner License # 619
  • National Certification Commission for Acupuncture and Oriental Medicine #12462
  • American Board of Oriental Reproductive Medicine Fellow

Matt Ferguson

  • Masters of Science in Acupuncture- Bastyr University- Kenmore, WA – 1996
  • Certificate in Chinese Herbal Medicine- Bastyr University- Kenmore, WA- June 1997
  • Washington State License-East Asian Medicine Practitioner License # 0000349
  • American Board of Oriental Reproductive Medicine Fellow

Andrea Iwi’ula

  • Masters of Science in Acupuncture- Bastyr University- Kenmore, WA- June 1998
  • Certificate in Chinese Herbal Medicine- Bastyr University- Kenmore, WA- June 2013
  • Washington State License - East Asian Medicine Practitioner License # AC00000474   8/28/98
  • New York State License- Licensed Acupuncturist # 004300-1 1/31/10
  • American Board of Oriental Reproductive Medicine Fellow

Julie Booker

  • Masters of Science in Acupuncture and Oriental Medicine – Northwest Institute of Acupuncture and Oriental Medicine – Seattle, WA – June 2003
  • National Certification Commission for Acupuncture and Oriental Medicine # 23914
  • Washington State License - East Asian Medicine Practitioner License # AC00002293
  • American Board of Oriental Reproductive Medicine Fellow

Natalie Willits

  • Masters of Science in Acupuncture and Oriental Medicine - Bastyr University- Kenmore, WA – 2016
  • Washington State License-East Asian Medicine Practitioner License # AC60722112
  • National Certification Commission for Acupuncture and Oriental Medicine #165598
  • Member of WEAMA – Washington East Asian Medicine Association
  • American Board of Oriental Reproductive Medicine Fellow

Amanda Fu-Kalilikane

  • Masters of Science in Acupuncture and Oriental Medicine - Bastyr University- Kenmore, WA – 2018
  • Washington State License-East Asian Medicine Practitioner License # AC60895286
  • National Certification Commission for Acupuncture and Oriental Medicine

Michele Morken

  • Masters of Science in Acupuncture and Oriental Medicine - Bastyr University- Kenmore, WA – 2018
  • Washington State License-East Asian Medicine Practitioner License #AC60813223
  • National Certification Commission for Acupuncture and Oriental Medicine

The scope of practice for East Asian medicine practitioners in the state of WA include:
 

  • Acupuncture: The use of pre-sterilized, disposable acupuncture needles or lancets to directly or indirectly stimulate acupuncture points and meridians.
  • Electrical, Mechanical or Magnetic Stimulation of Acupuncture Points: Using very small amounts of electricity to stimulate acupuncture points and meridians or using mechanical or magnetic devises to stimulate acupuncture points or meridians.
  • Moxibustion: A soft woolly mass prepared from ground young leaves, typically in the form of sticks or cones, which are ignited and placed on or close to the skin or used to heat acupuncture needles.
  • Acupressure: Traditional Chinese medical massage and manual therapy.
  • Cupping: Glass cups are placed on the skin with a vacuum created by heat or suction device.
  • Dermal-friction Technique (Gwa-sha): Friction is applied topically to the skin using a smooth object to relieve symptoms.
  • Infrared Heat: Applying heat generated by an infrared lamp over a specific area of the body.
  • Sonopuncture: The use of sound to stimulate acupuncture points or meridians.
  • Laserpuncture: Laser light beams are applied to the acupuncture points to help stimulate the flow of chi and promote healing.
  • Dietary Advice and Health Education Based on East Asian Medical Theory: Suggestions for nutrition and herbal food products including herbs, vitamins, minerals, and dietary and nutritional supplements.
  • Breathing, Relaxation, and East Asian Exercise Techniques
  • Qi Gong: Internal Chinese meditation practice that often uses slow graceful movements and controlled breathing techniques to promote the circulation of qi within the human body, and enhance overall health.
  • East Asian Massage and Tui Na: Bodywork characterized by kneading, pressing, rolling, shaking, and stretching of the body. This does not include spinal manipulation.
  • Superficial Heat and Cold Therapy
  • Point Injection Therapy: A procedure in which vitamins, herbal extracts, or other fluids are injected into the body at an acupuncture point using a syringe and needle.

Patients with bleeding disorders or pacemakers as well as pregnant patients
must inform the practitioner prior to receiving any treatment.

Potential Benefits: Drugless relief of presenting symptoms and improved balance of body energies that may lead to the prevention, improvement or elimination of the presenting problem.

Side effects may include, but are not limited to: Discomfort, pain, some pain following treatment in insertion area, minor bruising, a burn, blistering, bleeding, infection, numbness or tingling at or near the site of the procedure, temporary discoloration of the skin, broken needle, needle sickness, possible aggravation of symptoms existing prior to the acupuncture treatment, and dizziness or fainting. Bruising is a common side effect of cupping and injection therapy.  Unusual risks of acupuncture include spontaneous miscarriage, nerve damage, and organ puncture, including lung puncture (pneumothorax).

Consent For Treatment For Acupuncture

I acknowledge that it is my responsibility to seek the advice of a medical doctor or other primary healthcare provider as I see fit to ensure that in the event of serious illness, I do not unknowingly delay necessary medical treatment.

With this knowledge, I voluntarily consent to the above procedures and releases, realizing that no guarantees have been given to me by Acupuncture Northwest & Associates, including its employees, regarding cure or improvement of my condition. I hereby release Acupuncture Northwest & Associates, including its employees, from any and all liability, which may occur in connection with the above-mentioned procedures, except for failure to perform the procedures with appropriate medical care. I understand that I am free to withdraw this consent and to discontinue participation in these procedures at any time.

Notice of Privacy Practices- Acknowledgement

Acupuncture Northwest & Associates will keep medical records of the health care services we provide you. You may ask to see your records and request a copy. You may also ask to correct your records. We will not disclose your records unless you give us written consent or unless the law authorizes or compels us to do so. You may see or get further information about your records by contacting Acupuncture Northwest & Associates. Our Notice of Privacy Practices describes in more detail how your health information may be used and disclosed, and how you can access your information.

Consent for Exchange of Information
Within Acupuncture Northwest & Associates

I hereby authorize the exchange of information between the practitioners that I am seeing at Acupuncture Northwest & Associates.

Treatment and Payment Agreement

I agree to be responsible to Acupuncture Northwest & Associates for charges resulting from services rendered to me at their established rates. I agree all bills are due in full upon request. I understand that if my medical insurance policy provides minimum or no coverage for the care and treatment I received at Acupuncture Northwest & Associates, I am responsible for outstanding costs of these services.

Late Cancellation and Missed Appointment Policy

I acknowledge that Acupuncture Northwest & Associates has a 24 hour cancellation policy. I understand that if I miss a scheduled appointment, I will be charged for the full appointment fee. I understand that if I do not provide 24 hours notice for cancelling an appointment, I will be charged half of the appointment fee.

I understand that my insurance company cannot be billed for missed appointments or late cancellations therefore I agree to pay Acupuncture Northwest & Associates directly.

Certification

I certify that I have read and understand the authorizations given above and I am the patient, or I am duly authorized by the patient to execute the above and accept its terms.