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Please check the customer’s online consent before starting work (note: consent may also be given on paper)

Consent for massage

Patient Name:	Date	Patient Signature:	Practitioner Name
Paul Wu	09/28/2025		Paul Wu
Daniel Wu	09/28/2025		Paul Wu
Daniel Wu	09/09/2025		Paul Wu
Daniel Wu	09/28/2025		Paul Wu
Daniel Wu	09/28/2025		Paul Wu
Fansheng	09/18/2025		Paul Wu
Fansheng	09/18/2025		Francis Meng

Consent for acupuncture

Patient Name:	Date	Patient Signature:	Practitioner Name
Daniel Wu	09/28/2025		Paul WU
Daniel Wu	09/28/2025		Paul Wu
Fansheng	09/11/2025		Francis Meng
paul wu	09/05/2025		Paul Wu

Consent for sensitive treatment

Name of patient or the substitute decision-maker (SDM)	Date	Signature of Patient/SDM:	Describe specific treatment or specific plan of treatment (e.g., acupuncture and herbal prescription)	please check the appropriate box(es)	Practitioner Name
Daniel Wu	09/28/2025		massage	Buttocks	Paul Wu
Mike Li	09/14/2025		massage	Buttocks	Paul Wu
Mike Li	09/09/2025		dfda	Buttocks	Francis Meng
paul wu	09/05/2025			Buttocks	Paul Wu

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