Five Element Acupuncture Practice

Session Date:

Session Time:

I. Patient Assessment

II. Treatment Planning

III. Live Treatment

IV. Session Review

I. Patient Assessment

Primary Constitutional Type:

Secondary Type:

Symptom Categories: Hold Ctrl/Cmd to select multiple categories

Detailed Symptom Description:

Tongue Assessment

Observe tongue for no more than 20 seconds. Look from tip to back, then sides.

Tongue Body Color:

Tongue Coating:

Tongue Texture:

Tongue Movement:

Tongue Tip (Heart/Emotional state):

Tongue Sides (Liver/Gallbladder):

Additional Tongue Observations:

Pulse Diagnosis

Left Hand Pulse Positions

Cun Superficial (Small Intestine):

Cun Middle (Heart):

Cun Deep (Heart):

Guan Superficial (Gallbladder):

Guan Middle (Liver):

Guan Deep (Liver):

Chi Superficial (Bladder):

Chi Middle (Kidney):

Chi Deep (Kidney):

Right Hand Pulse Positions

Cun Superficial (Large Intestine):

Cun Middle (Stomach):

Cun Deep (Lung):

Guan Superficial (Stomach):

Guan Middle (Spleen):

Guan Deep (Spleen):

Chi Superficial (Triple Warmer):

Chi Middle (Pericardium):

Chi Deep (Pericardium):

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Session Notes:

II. Treatment Planning

Causative Factor (CF):

Treatment Strategy:

Point Selection

Search Points (by name, element, or spirit):

Available Points:

Selected Points:

No points selected yet

Treatment Rationale:

III. Live Treatment

Needle Size:

Average Depth:

Point-by-Point Treatment Log

Points will appear here after you save a treatment plan.

Patient's Immediate Response:

Homework/Recommendations:

IV. Session Review

Overall Session Quality:

Recommended Next Session:

Practitioner Reflections:

Patient Feedback (to be added after session):

Five Element Acupuncture Practice

I. Patient Assessment

Tongue Assessment

Pulse Diagnosis

Left Hand Pulse Positions

Right Hand Pulse Positions

Save This Assessment

II. Treatment Planning

Point Selection

III. Live Treatment

Point-by-Point Treatment Log

IV. Session Review

Saved Assessment Sessions