FAQs and Forms
When you arrive for your appointment,
we'll have a one page appointment intake form for you to fill out. Your detailed answers help Ryan understand the progression of your recovery and health concern(s). The clearer a picture he has - the more detailed and accurate Ryan can be in understanding the conditions that contribute to your health
concern(s), to design your treatment plan.
Click on these links, or simply continue reading.
Your participation in your own health
is by far the most important key to your
core healing success.
Core Healing's new client health history is likely much more extensive an inventory than you are accustomed to for - but for good reason: you!
Each question we ask has relevance. Please give as complete an answer as you can. All information is for Ryan's reference, and to meet HIPAA informed consumer compliance, it is private, safely filed and stored.
New clients only: please bring a completed New Client Form Packet to your first appointment, or arrive early to complete this important paperwork.
All clients, once established, 'check in' with a single Appointment Intake Form, each appointment. Please feel free to print and fill in this form, to bring, in advance of your appointment.
New Client Forms
Save a tree, print double sided.
Class, workshop or retreat student forms
This completed form is necessary for Core Healing class, workshop, or retreat attendance.
New To Acupuncture?
Information and details about treatment
quickly dispels intimidation, or worries of
'the unknown' we sometimes feel about new medical care in our lives.
This is a core healing experience
you can look forward to.
With respect to the urgency of your treatment event, avoid scheduling your appointment time before or after strenuous activity, or between stressful, or time sensitive events.
Before and after treatment your energies will tend to focus in support of healing.
Healing happens according to the intentional energy and support we give it.
Use your full appointment time to cultivate a deep, relaxing, healing experience.
Commit to your full treatment plan, which will likely be more than one session.
Your appointments and the healing intervals between are important to your overall treatment plan.
Confirm, if applicable, that health records and results (x-rays, labs etc.) are on file/available to Ryan in advance of your appointment, or, take copies of them with you to the appointment. Take a picture of medication labels/doses as an easy means of sharing this important information with Ryan.
If you need to cancel your appointment, giving as much notice as possible allows us to find you an alternate time slot best for your continued health progress and scheduling needs.
Generous cancellation notice helps us offer that slot to another client in need, and helps you to avoid any cancellation fee.
How often will I receive treatment?
Just as two people with a same health concern experience it differently, each appointment, appointment experience, and so each treatment plan, is unique, organic.
Ryan will schedule your course of treatment accordingly.
Many health insurance companies require a pre-treatment plan submission
before services can be offered.
Following such approval, it is typical for clients to have multiple treatments for a serious health concern, with integration time allotted between appointments. Your obvious and subtle response systems will be hard at work between actual treatment appointments: healing, re-balancing. Time between treatments assures your systems will not be overwhelmed with their respective working-healing loads.
On your appointment day
Busy lives and work schedules aside, ideally, supportive activities before and after your treatment include: moderation in activities, adequate hydration and rest, mind-body awareness including stillness, and conscious intake of health promoting foods.
Acupuncture quiets the parasympathetic system, our fight-flight response, which in turn elicits deep stillness and renewal during and after a treatment. Therefore, a good rule of thumb is to avoid coffee and alcohol at least two hours before and after a treatment. Caffeine, a stimulant, prohibits this deep relaxation. Alcohol, a depressant, lowers subtle energy awareness, and impairs senses and receptor responses, affecting Ryan's ability to read your subtle energy and body feedback systems - which can then affect treatment efficacy.
DO drink a little water before your treatment; for grounding, re-balancing, and to boost your electrical system, which requires water to perform, to be healthy, to heal. Water creates a chemical reaction at a cellular level, supporting cellular health, electrical system balance, and all mental and physical systems in releasing toxic residue.
DO eat a little. A small amount of healthy food ingested will fuel your session: during and after.
Whole foods like fruits, vegetables, or small protein rich snacks low in sugar best support body wellness.
DO turn your cell phone off, not just to vibrate, if possible. It's rare in our busy, multi tasking world, to have an opportunity to quiet all the demands constantly made on our bodies and brains. Claiming this deeply renewing time is a powerful message you send yourself and others as to the value of your healing.
What to wear during treatment
Please remove jewelry and socks. Sports bras and underwear or shorts are fine to wear during your session. This allows access to acupuncture points and manual therapy treatment areas.
If you're more comfortable completely disrobed, be assured you'll be professionally draped, (covered), at all times, resting easily on a warm treatment table, in a quiet, clinical, professional environment.
Additional heat and deeply healing infrared therapies are helpful, and commonly used - especially welcome during Alaskan winters!
'The big picture', what this kind of care provides:
- greatly improved overall health
- cessation of the more immediate symptom you are experiencing.
How Will I Feel?
Soon after a treatment begins, and during treatment, most clients fall into a relaxed restful quiet, often describing clarity, peace, and energy burst states afterwards.
This is the immediate action of the 'feel good' neurotransmitter hormones quickly accessed and activated via treatment.
not experienced acupuncture
sometimes expect to feel pain from
acupuncture needle insertions.
Ryan's gentle method of placement
quickly dispels such concerns.
Acupuncture's flexible, hair-thin, single use sterile needles have no relationship or similarity to the type, size, placement or applications of those used in conventional medical settings.
When the needle placements have been balanced at the correct depth, occasionally clients experience a mild, dull/aching sensation, which quickly passes.
This feedback indicates activation of exactly the energies acupuncture uses to restore energy to electrical systems, and circulation to organ systems: vital for best functioning and health.
Responses to treatment - important to know!
There is no 'normal' - there is what your body needs for healing, and, this is unique to you.
Eventually what is normal is the optimal state of being calm and energized.
Some people have more layers of detoxification to express: nervous system balancing, tensions blocking circulation flow, inflammation to resolve...
Sometimes people are surprised that even a gentle, seemingly subtle treatment can have such profound effects, not realizing that the subtle can go deeply into the system to achieve powerful healing.
After a treatment it is important to hydrate well.
Sometimes people experience aching as the body moves circulation in, and inflammation out.
This process resolves much more quickly with hydration: the intake of fresh, clean water.
It is usually best to not do vigorous exercise right after, or even the day of a treatment.
Your body needs time to integrate the treatment, and often needs time for 'repair mode' wherein the body is resolving inflammation, detoxifying, and getting the improved, clearer circulation to layers of the body
that need healing. Excessive or stagnant vitality patterns are now more freely moving through the body-mind matrix.
Gentle movement, such as walking, is almost always good.
Even better are such body mind exercises as Tai Chi and Qi gong; to help the body integrate the treatment.
Remember that the treatment is truly holistic, which, while meaning 'whole body', also includes
the other layers of your being, such as mind and emotions.
Facilitate the treatment through fluid (hydrating), gentle movement, and listening to your body.
If it needs rest, for instance, allow the treatment more opportunity to continue its positive effects by resting.
Conversation during treatment often happens,
this is a healing experience in itself.
As a treatment, or series of treatments progress, both client and practitioner
have the opportunity to tune-in to health cues the body speaks.
Practitioners ascertain valuable
progress and treatment need information in this listening.
Clients find healing, peace, and gain powerful insights into their systems.
The process of whole-healing
can feel foreign, perhaps uncomfortable,
as new, more foundational balance is being restored.
Recognizing the familiar and improved health states we've been seeking is a deeply rewarding health experience.
How Acupuncture Works
Acupuncture activates and influences pain suppressing receptors, increasing the concentration of adenosine; a neurotransmitter in local tissues which becomes active after an injury, to ease pain, and also, Substance P; a potent neurotransmitter important to several physiological and pathological functions including vasodilation, pain, no-ciception (how the central nervous system responds to stimuli), anxiety, inflammation, and neurogenesis. Adenosine slows brain activity, and can induce sleepiness; one of the ways acupuncture is a helpful insomnia treatment.
By down-regulating (turning off) pro-inflammatory cells known as M1 macrophages, and up-regulating (activating) anti-inflammatory M2 macrophages, acupuncture reduces pain and swelling.
Acupuncture can target pain both locally and systemically, and can be used as an anesthetic agent.
Ryan's use of multiple healing modalities during sessions maximizes and boosts the body's natural healing capacity.
Does health insurance cover my treatment?
Many insurance companies cover acupuncture and manual therapy treatment, often with a set number of treatments per calendar year. Some plans require a referral from a conventional-medicine doctor.
After an initial consultation, Ryan may be required to submit a treatment plan to your insurance company, After approval, you'll begin treatment.
Your health insurance company can tell you your plan's benefits and co-pays.
Unfortunately, Medicare does not cover treatment at this time.
Acupuncture licensure requirements
Alaska’s acupuncturists are licensed with proof of successful national examination and certification.
The National Certification Commission for Acupuncture and Oriental Medicine, (NCCAOM), one of two nationally recognized authorities, certifies acupuncturists after their extensive training and examination.
All States that regulate acupuncture require national certification exams. California, which introduced eastern medicine to the western world, establishes stringent standards of practice that continue to evolve national and state standards and licensing via additional exam and certification processes. Acupuncturists license in California and their state of employment to demonstrate an extra level of competency.
A doctorate degree is the most advanced degree a practitioner can earn, symbolizing mastery in the TCM (Traditional Chinese Medicine) specific area of study, profession, requiring a significant level of research and practice articulation.
An acupuncturist certified by the NCCAOM is called a Diplomate of Acupuncture (Dipl.Ac.) - having demonstrated significant expertness in the full range of the Oriental medicine branches, extensive clinical experience, training in standard medical history gathering and medical practitioner consultation, safety, and ethics, and in patient referral needs; at least three (full) academic years, and *a minimal of 1905 hours study. - *National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM)
Ryan's initial graduating studies: well over 3300 hours.
Licensed in both Alaska and California, Ryan maintains over 200 hours, yearly,
continued education, and, in multiple fields of TCM study.
California's continuing education requirements are 50 hours+ per year, Alaska's: 15.
“L.Ac.” after an acupuncture practitioner’s name indicates the practitioner is a Licensed Acupuncturist (L.A.c.), who has completed education at a nationally accredited school, having passed national board exams, which then allows licensure to practice acupuncture, and for some, in one or more states.
All licensing states mandate a certain amount of annual continued education for Traditional Chinese Medicine (TCM) professions.
What differentiates one TCM practitioner from another?Past credentials, recommendations from friends, colleagues, and medical professionals - past testimonials and reputation and results - we choose health care providers who demonstrate a well rounded knowledge of their profession and specialties. We like a welcoming calm, a warm attitude, professionalism, a feeling a 'connection' to the practitioner or practice by the way the practitioner represents themselves, it.
Study and licensure presumes an acupuncturist both honors and practices the Five Branches of Traditional Chinese Medicine care, which improves and informs both professional service and practitioner health. Exemplifying this lifestyle, the practitioner then has more health energy and awareness to contribute to clients' treatments.
The traditional function and desire of an eastern medicine practitioner is to heal others - but also, to educate and empower a client with Five Branches of Medicine resources: to strengthen, improve and deepen health at all levels, and to expand understanding and connection to mind-body health overall.
I have been working with Ryan Marshall since 2012
to resolve multiple health and pain issues:
long term consequences and ongoing impacts of
multiple car accidents and injuries.
His level of care and concern is truly amazing, and I have had
significant health improvements in the last four years.
As a result of working with Ryan, I have changed my diet, I exercise regularly,
and have lost a significant amount of weight
because of the reduction of pain and inflammation in my body.
Through treatments with Ryan I was able to avoid using pain medications after a recent surgery, and I no longer take any prescription medications or NSAIDS:
both important goals to me.
I’m able to walk, hike, do tai chi, and I hope to snow shoe this winter.
Frankly, I feel 20 years younger and like a new person who is
healthier, happier, more grounded, and embracing life again.
Confidence in your Care
Acupuncturists first undergo years of extensive, expert supervised training in anatomy, physiology, biology, chemistry, nutrition, clinic, and thorough needle specific work.
Then, having examined by nationally accredited organizations, acupuncturists are legally licensed in single, or multiple states, and with a defined scope of practice.
Many acupuncturists are further trained in advanced orthopedics, sports acupuncture, and other complementary energy and manual therapy modalities.
Practitioners' active and ongoing commitment to continuing education betters theirs' and clients' health, and is mandated in most licensing states.
What is Arm Chair Acupuncture?
Sometimes called 'community acupuncture', this type of session model by-passes individualized appointments and treatment, attention to health history, and privacy and confidentiality - in favor of shorter, lesser priced sessions. Acupuncture is offered to multiple participants, seated in a public space, everyone treated together. Needle placements are typically limited to arms and head only.
Community acupuncture can be a means of introducing novice health consumers to acupuncture - with the understanding it does not represent all that acupuncture and individually treatment plans offer.
Community acupuncture sessions are abbreviated in scope, time and followup. It does not address, treat, or provide followup on specific health concerns, nor does it provide detailed care and monitoring of recipients.
Acupuncturists commit to advanced studies and education in order to improve community and client health with their practice - and welcome the availability of health insurance and acupuncture coverage for previously uncovered individuals; to encourage optimal consumer and acupuncture health care advocacy, to support the important, complete experience of the single client, focused-care model.
What Is Dry Needling?
It is a testimony to the efficacy and growing popularity of acupuncture, and of the care and training of excellent acupuncturists that we see an explosion of conventional healthcare providers offering dry needling as part of their care services. However, caution, and consumer vigilance is required to understand that one form of acupuncture care does not equal the other.
‘Dry needling’ is the term coined by health care practitioners who perform an abbreviated form of acupuncture without the training and experience required of acupuncturists (3000+ hour nationally certified program addressing the multiple systems and aspects of related care, and specific, clinical needle use, and adequate clinical needle experience with acupuncturist oversight.
Physical therapists performing dry needling, train typically via a 27-72 hour acupuncture-unaccredited program, without clinical needle training, and without clinical/acupuncturist oversight.
Medical acupuncture physicians receive 80-120 hours acupuncture training.
Use of acupuncture needles to penetrate the skin, to stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments - is the definition of acupuncture.
A careful, considered attempt is being made by lobbyists, proponents, and untrained professionals performing 'dry needling' (in wording, advertising, explanation and ultimately use) - to make a distinction between dry needling and acupuncture, to avoid legal, ethical, and consumer health challenge.
Assuming dry needling is 'all there is' to acupuncture is harmful to everyone involved.
Physical therapists, chiropractors, medical doctors, and acupuncturists study, certify - and are licensed in, and restricted to, their studied speciality area, accordingly. State law and licensing defines scope of practice. In Alaska, and most other states, acupuncturists are legally and professionally deemed the health care providers trained and licensed to perform acupuncture.
DN (Dry Needling), Myofascial Trigger Point Needling, and/or Intramuscular Stimulation (IMS),
should not be performed by anyone other than a
licensed Acupuncturist and/or
Medical Doctor with a certification in Medical Acupuncture:
- The Acupuncture and Oriental Medicine Association of Alaska,
- The Council of Colleges of Acupuncture and Oriental Medicine,
- The American Association of Medical Acupuncturists.
Physical therapists and other non-physicians practicing dry needling should – at a minimum – have standards for training, certification and continuing education that exist for acupuncture.
- The American Medical Association (AMA)
CAM and CARA Support
(Complementary Alternative Medicine and The Comprehensive Addiction and Recovery Act)
New legislature designed to improve care for veteran addiction challenges, and CAM health care choices was signed into law, in early 2016, by then President Obama, with $181 million dollars appropriated yearly, with the intention of increasing acupuncture availability in multiple combat care and recovery care arenas as well, and improve availability of CAM and integrative care services to veterans.
The Comprehensive Addiction and Recovery Act of 2016 (CARA) intended to;
- address the serious prescription drug abuse problem in the U.S, via CAM (Complementary Alternative Medicine),
- expand research, education, and delivery of complementary and integrative health to veterans via the “Creating Options for Veterans’ Expedited Recovery” Commission (COVER).
The U.S. is facing a national opioid epidemic, leaving most families untouched by the drug, or the devastation of use, abuse, effects, death. The fatal overdose rate among VA patients is nearly double the national civilian average.
As of March, 2018, Acupuncturists in the VA now have a government standard (GS) range of GS 9 -12, recognizing Acupuncturists' level of education, training, and experience.
Acupuncture, now emerged as a powerful, evidence-based, safe, cost-effective treatment means thousands of veterans suffering from debilitating pain and opioid addiction have increased access to acupuncturists at more Veterans hospitals and medical centers.
sources: https://www.congress.gov/114/bills/s524/BILLS114s524enr.pdf, http://www.nccaom.org/blog/2018/03/01/acupuncturists-in-va/
Our Core Healing team are proud supporters of our military personnel and families' health; improving our military communities' health care with effective, empowering, expanded treatment choices.
Acupuncture For PTSD
Long after the original impact, physical and emotional trauma still affects the nervous system, which, many times stays frozen and ‘on alert’ until a discharge of that held energy can occur. Energetic movement created by acupuncture and TCM techniques facilitate that release.
For more studies, statistics, and news about acupuncture, TCM, and Core Healing methods of healthcare, see our TCM In The News page:
- Dr. Ryan Marshall, DACM, Dipl. A.c, LA.c
"To relieve pain
and inflammation -
I work with patients
to revive and align
their inherent healing processes."