(a) Prior to providing any complementary or alternative drug, treatment, device, or intervention, the physician and patient must review and execute the below disclosure and consent form. The fully-executed form must be included in the patient's medical records. Other than translation into another language or format for the patient, this form may not be changed, modified, or altered in any manner other than by adding additional pages with supplemental information as necessary. (b) The physician practicing complementary and alternative medicine must follow all statutes and rules including requirements for maintaining adequate medical records. Physicians must also document and maintain within the medical record the information either as set forth in the form below or in an alternate format that contains at least the information requested in the form below:Attached Graphic