Standards: Patient Safety and Terms of Acceptance

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  • September 26, 2014

Vol. 5, No. 7, May 1996


The NUCCA chiropractic practice is a limited, primary health care profession.

NUCCA chiropractors may receive patients directly, without referral from another provider.

The NUCCA chiropractic practitioner’s responsibility and authority are limited to the anatomy of the spine; the condition of the vertebral subluxation, and a scope of practice which encompasses addressing the vertebral subluxation as well as educating patients and advising them about the subluxation.

As members of a limited, primary profession , NUCCA chiropractic practitioners have the responsibility to determine the safety and propriety of applying their methods of analysis and adjustment to their patients; to recognize and appropriately deal with emergency conditions as described by the International Red Cross; and to report to the patient any non-chiropractic findings the chiropractor considers unusual discovered during the course of locating and characterizing the vertebral subluxation. The limited nature of the profession dictates a responsibility and authority requiring the NUCCA chiropractor, in the interest of safety, to refrain from offering advice, diagnosis, prognosis, or treatment of non-chiropractic findings, while continuing to address the chiropractic needs of the patient.


The professional practice objective of a NUCCA chiropractor is to correct the vertebral subluxation in a safe and effective manner. The correction of the subluxation is not considered to be a specific cure for any particular symptom or disease. It is applicable to any patient that exhibits a vertebral subluxation regardless of the presence or absence of symptoms or disease.

Managing the patient to a biomechanical conclusion far exceeds patient management based on symptomatic relief. Monitoring the patient’s progress with x-ray analysis and instrumentation objectively identifies the success or failure of the NUCCA practitioner to restore normal form and function. It objectively identifies maximum improvement and residual impairment.


A. Case History

The NUCCA chiropractor shall compile a Case History to elicit information to assist in the administration of safe and effective care.

B. Chiropractic Analysis

The NUCCA chiropractor shall perform a Chiropractic Analysis for the determination of the presence and character of the vertebral subluxation.

C. Chiropractic Findings

The chiropractor shall inform the patient of chiropractic findings.

D. Unusual Findings

Findings considered unusual by the NUCCA chiropractor, both related and unrelated to the vertebral subluxation, which present in the course of chiropractic analysis should be recognized and recorded.

E. Report of Findings

The patient must be informed of unusual findings related and unrelated to the vertebral subluxation. This includes information about which the NUCCA chiropractor does not offer advice, assessment of significance, diagnosis, prognosis or treatment for such findings, while continuing to address the chiropractic needs of the patient. The patient’s acknowledgment of such findings must be recorded.

F. Plan of Care

The patient must be provided with a description of a plan of care for addressing the chiropractic findings.

G. Referral

a. Intraprofessional Referral:

1) The NUCCA chiropractor should refrain from further care when the atlas subluxation is not being reduced and either consult with or refer the patient to another NUCCA chiropractor who, by virtue of ability or experience, may more effectively address the patient’s atlas subluxation.

b. Interprofessional Referral: In the delivery of NUCCA chiropractic care, a practitioner may encounter findings which are outside the professional areas of scope, responsibility, or authority to address. The NUCCA chiropractor has a responsibility to report such findings to his/her patient, and record their existence.  Additionally, the patient should be advised that it is outside the responsibility and scope of the NUCCA chiropractic practitioner to offer advice, assessment of significance, diagnosis, prognosis, or treatment for said findings and that, if the patient chooses, he/she may consult with another provider, while continuing to have his/her chiropractic needs addressed.

H. Terms of acceptance

The NUCCA chiropractor should establish the Terms of Acceptance, constituting an informed consent of a general nature which benefits both the patient and the NUCCA chiropractor. This agreement provides the patient information upon which to base his/her decision to accept care. Included in the agreement are the NUCCA chiropractor’s areas of responsibility and authority; professional objective; main area of interest; limitations and other areas. These topics adequately convey the reasonable benefits available to the patient and engender a proper patient expectation. The patient acknowledges an understanding of these concepts prior to the initiation of care. It is highly recommended the Terms of Acceptance should be re­ corded.

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