Join the ASA’s Medicare advocacy efforts by collecting testimonials from your patients to support H.R. 4803, The Acupuncture for Our Seniors Act. Patient testimonials are a great way to engage your patients and educate legislators on the benefits of receiving acupuncture. The Patient Testimonial Kit includes four documents that will guide you, and your patients, in gathering and submitting effective testimonials. You can choose to print out the forms and distribute them to your patients to complete and then return via email, or for patients that are comfortable completing these forms electronically, you can email them a link to our Google form.
For you, the practitioner:
- Practitioner Guide – Gathering Effective Testimonials – English – An overview of important considerations in English.
- Practitioner Guide – Gathering Effective Testimonials – Chinese – An overview of important considerations in Chinese.
- Sample Letter to Patients – You can customize and send to your patients to explain why we are asking for their testimonials.
For your patients to complete:
- Patient Testimonial Worksheet & Testimonial Form – Will assist patients in writing an effective testimonial.
- Authorization Form – Each patient testimonial must include a signed authorization form to be eligible for use.
Return completed print copies of the patient testimonials and their signed authorization form by emailing to: email@example.com
Patients that use the Google form to complete their testimonial will submit their documents electronically once completing all steps within the Google form.
* Each testimonial must include an Authorization form signed by the patient to be eligible for use.