New Patient Commitment Form

We require you to read this form first as it will clearly lay out what you can expect as a new patient and the steps you will need to take to gain maximum benefit from your treatment.

Health has a lot to do with personal responsibility. Our clinic can certainly offer you guidance and support in overcoming chronic health conditions or pain. But it will ultimately be up to you to be accountable for your own health by being compliant with the lifestyle recommendations we offer, whether they be dietary, exercises, or stress reduction techniques, etc.

There is an assumption that naturopathic medicine and/or acupuncture works like magic and all they have to do is show up for treatment and their health problems will disappear. This is not the way that naturopathic medicine or Chinese medicine works, especially with chronic health issues. We have to work together as a team and implement a variety of lifestyle strategies for naturopathic medicine and/or acupuncture to work on the deepest level possible. If you have been told “acupuncture (or naturopathic medicine) should work on the first treatment or else it's not going to work at all", this is false information and we encourage you to consider otherwise.

For example, many times the effects of acupuncture will take hold after an initial series of 6-10 treatments depending on your situation. Sure, there are times where you'll feel amazing after the first treatment, but for chronic issues you can expect it to take some time.

Here are some of the steps you will need to take to gain maximum benefit from your treatment. Dr. Nicole Fujiyama, ND, L.Ac. is very excited to work with you if you are willing to hold yourself accountable to these very important actions steps:

#1 Consistency in Treatment--

On your first visit, we will discuss frequency and number of treatments to reach maximum progress. We ask that you make a commitment to the treatment plan by making your visits a top priority. Acupuncture and naturopathic medicine work best with consistent and cumulative care.

#2 Eat an organic whole foods diet--

This is one of the most important steps you can take to heal all kinds of chronic issues. Many of our patients are asked to undergo allergy elimination protocols as well in order to achieve optimal benefit.

#3 Exercise 3-4 times per week--

Walking, stretching, yoga, biking, etc., some kind of movement preferably you can find something you enjoy

#4 A few minutes a day of quiet time and introspection--meditation is ideal for this purpose.

#5 Willingness to let go of addictions or habits that are undermining your health

We have found that Naturopathic and Chinese medicine can work on very profound levels if these basic steps are taken.

We only ask that you do the best you can to follow these guidelines, as they will ensure that you receive the full benefit from our care.

We'd like to share with you an overview of the patient that does best with our approach. Our ideal patients:

• are willing to take responsibility for their health--they are not just looking for a magic bullet that will instantly cure their issues

• are interested in working with their minds by discovering and liberating harmful or limiting beliefs (our approach to medicine very much honors the powerful role the mind plays in our health)

• are generally interested in living with purpose and in balance

• are compliant--they are happy and committed to making recommended lifestyle changes and to followed their prescribed treatments

• value their health and the treatment process--they make a commitment to showing up on time for treatment and sticking to their appointments because they know how important it is.

• see Chinese medicine and/or Naturopathic medicine as a lifestyle choice-generally we don't see patients that just have a specific pain they want to go away in 1 or 2 treatments and then they never come back.

• are eager to learn and grow

If this describes you, great! We'd love to have you at our practice and you should do very well with our approach.

Then please call us at 310-340-0242 and we'll get you in just as soon as we can!

1110 Crenshaw Blvd, Torrance CA 90501 |        Ph: (310) 340 - 0242 |  Fax: (714) 933-4377

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