1. health and fitness
2. disease

Sample Patient Report
940 E. Carol Street • Meridian, Idaho • 83646 • USA • 208-846-8448 • www.acugraph.com
Note:
This packet contains a sample patient report, printed
from AcuGraph 3. We’ve also included a few notes about
how to read the reports.
The following page is the “Screening Report” designed for
use at public screenings and practice-building events.
This one-page report shows the patient’s results
compared with the ideal result and discusses the
meaning of these results.
The blue text is fully customizable for your practice
information.
Meridian Energy Screening Report
Your Measurements
Ideal Measurements
PIE: Your Personal Integrated Energetics™ (PIE) score is 72. This score is a reflection of the relative energetic balance
within your acupuncture meridian energy system. The ideal score is 100. A less-than-ideal score reflects energetic
imbalances that may lead to poor function and impaired health. A very low score may indicate serious problems. Your
healthcare provider can provide you with complete information about your imbalances, potential consequences, and
recommended treatments to restore your energetic balance.
200
175
150
140
125
115 112 114
101
100
87
75
104
108 110
94
112 112
L R
L R
110
116
110 108
88 90
88
60
50
108 110
148
98 98
56 52
25
0
L R
LU
L R
PC
L R
HT
L R
SI
L R
TE
L R
LI
SP
LR
L R
KI
L R
BL
L R
GB
L R
ST
According to acupuncture theory, energy imbalances or blockages in the acupuncture meridians may lead to
health problems, pain and disease. Acupuncture practitioners restore proper function and optimum health by
removing these blockages and restoring balance to the acupuncture meridians. Your practitioner can provide
you specific information about your particular imbalances, their impact on your health, and appropriate
treatments.
Your follow-up consultation has been scheduled for ________________ at _______ a.m./p.m. Please bring
this report with you to your appointment.
Example Patient
Dr. Name Here
Clinic Phone Number / Fax number here
2/12/08 4:23 PM
Clinic Address
Clinic Address 2
City, State, Zip
Source Points
Clinic Name Here
Website here/email here
Note:
The next pages contain the full patient report. Within the
AcuGraph software, you can choose which items to include in the
full patient report, making it as concise or as detailed as you
desire. For this sample, we’ve included some of the most popular
report items.
A single-page “Notes” report is also available, which is suitable
for keeping on file with patient records.
Graphs are color-coded to demonstrate excessive, deficient, split
and normal meridians, as shown in the example graph above.
“Normal” is considered the range between the red and blue
horizontal lines.
Exam Findings
Example Patient - 2/12/08 4:23 PM - Source Points
Example Patient - 2/12/08 4:23 PM - Source Points
200
175
150
140
125
115
112 114
104
101
100
108 110
108 110
94
87
112 112
110
148
116
110 108
98 98
88 90
88
75
60
56
50
52
25
0
L R
LU
L R
PC
L R
L R
HT
High:
L R
SI
TE
Low:
L R
LI
L R
SP
Split:
L R
LR
L R
KI
L R
BL
L R
GB
L R
ST
Normal:
Example Patient - 2/12/08 4:23 PM - Source Points
Yin: 106
200
Yang: 98
175
150
140
125
115
112 114
104
101
100
87
108 110
108 110
112 112
110
148
116
110 108
94
98 98
88 90
88
75
60
56
50
52
25
0
L R
LU
L R
High:
PC
L R
L R
HT
SP
Low:
Example Patient
Dr. Name Here
Clinic Phone Number / Fax number here
L R
LR
L R
KI
Split:
2/12/08 4:23 PM
Clinic Address
Clinic Address 2
City, State, Zip
L R
SI
L R
TE
L R
LI
L R
BL
L R
GB
L R
ST
Normal:
Source Points
Clinic Name Here
Website here/email here
Example Patient - 2/12/08 4:23 PM - Source Points
200
Metal: 101
Minister Fire: 68
Emperor Fire: 100
Earth: 103
Wood: 110
Water: 128
175
150
140
125
115
112 114
108 110
104
101
100
94
88 90
87
108 110
112 112
110 108
L R
L R
110
148
116
98 98
88
75
60
56
50
52
25
0
L R
LU
L R
LI
L R
L R
PC
High:
L R
TE
HT
Low:
Metal
3AM-7AM
L R
SI
L R
SP
Split:
Earth
7AM-11AM
L R
ST
LR
GB
L R
KI
L R
BL
Normal:
Example Patient - 2/12/08 4:23 PM - Source Points
Emperor Fire
11AM-3PM
Water
3PM-7PM
Minister Fire
7PM-11PM
Wood
11PM-3AM
200
175
150
140
125
115 112 114
108 110
101
100
88 90
87
148
108 110
98 98
110
94
116
104
110 108
112 112
L R
L R
88
75
60
50
56
52
25
0
L R
LU
L R
High:
LI
L R
L R
ST
SP
Low:
Example Patient
Dr. Name Here
Clinic Phone Number / Fax number here
L R
HT
L R
SI
Split:
2/12/08 4:23 PM
Clinic Address
Clinic Address 2
City, State, Zip
L R
BL
L R
KI
L R
PC
L R
TE
GB
LR
Normal:
Source Points
Clinic Name Here
Website here/email here
Example Patient - 2/12/08 4:23 PM - Source Points
84
(=)
(-)
(=)
(X)
110
103
(=)
(=)
(=)
(=)
(=)
(=)
(+)
(=)
101
128
High: (+)
Low: (-)
Split: (X)
Normal: (=)
Example Patient - 2/12/08 4:23 PM - Source Points
109
54
TE
(-)
82
113
GB
(=)
KI
(=)
ST
(=)
SI
(=)
91
Example Patient
Dr. Name Here
Clinic Phone Number / Fax number here
LU
(=)
LI
(=)
144
Low: (-)
113
LR
(=)
PC
(X)
BL
(+)
High: (+)
112
Split: (X)
2/12/08 4:23 PM
Clinic Address
Clinic Address 2
City, State, Zip
89
98
SP
(=)
HT
(=)
109
109
Normal: (=)
Source Points
Clinic Name Here
Website here/email here
Example Patient - 2/12/08 4:23 PM - Source Points
High:
Low:
Split:
Normal:
Example Patient - 2/12/08 4:23 PM - Source Points
Upper/Lower Balance:
21% Lower
L/R Imbalance
4% Right
67%
101%
+
Chi Energy Level: 101%
(normal)
Energy Stability
67%
(Within Low
Normal Limits)
Yin/Yang Balance: 8% Yin
Example Patient
Dr. Name Here
Clinic Phone Number / Fax number here
2/12/08 4:23 PM
Clinic Address
Clinic Address 2
City, State, Zip
Source Points
Clinic Name Here
Website here/email here
Meridian Analysis Information
PC(X)
The Pericardium Meridian (circulation/sex meridian) governs circulation and hormones, and protects and
regulates the heart.
Your Pericardium Meridian is split. This means there is a significant imbalance in this meridian's energy
between the right and left sides of your body.
Energetic disturbances in the pericardium meridian may involve one or more of the following emotional
factors: the ability to feel and express positive emotions
Split chi in the pericardium meridian may indicate a potential for diseases of heart, chest, stomach, upper
extremity, hormones.
Imbalance in this meridian may be associated with subluxation at the T2, T4, T8 and/or T12 level(s).
TE(-)
The Triple Heater (triple warmer) Meridian governs respiration, digestion and elimination.
Your Triple Heater (triple warmer) Meridian energy is deficient.
Energetic disturbances in the triple heater meridian may involve one or more of the following emotional
factors: the ability to feel and express positive emotions
Deficient chi in the triple heater meridian may indicate a potential for respiration disorder, nausea, stomach
disorder, cold, fatigue, endocrine dysfunction, pain in temples, nervousness, diarrhea, enuresis, edema.
Imbalance in this meridian may be associated with subluxation at the T2, T3, L1, and/or Sacrum level(s).
BL(+)
The Bladder Meridian functions with the Kidney Meridian in water metabolism and excretion. All the
associated (Shu) points are on this meridian.
Your Urinary Bladder Meridian energy is excessive.
Energetic disturbances in the urinary bladder meridian may involve one or more of the following emotional
factors: Anxiety, Paralyzed will, Holding on to old ideas, Timidity, Inefficiency, Fear of letting go, Wishy-washy,
Irritation.
Excessive chi in the urinary bladder meridian may indicate a potential for neck and back pain and stiffness,
disorder of lower extremities, eye pain, tears, brain disease, vertigo, headache along meridian, bladder
disorder, prostate disorder.
Imbalance in this meridian may be associated with subluxation at the L5, S1 and/or S2 level(s).
Element Information
Your most dominant element is Water.
• Sense Organ: Ears
• Tissue: Bone
• Taste: Salty
• Color: Blue/Black
• Sound: Groaning
• Odor: Putrid
• Emotion: Fear
• Season: Winter
• Environment: Cold
Example Patient
Dr. Name Here
Clinic Phone Number / Fax number here
2/12/08 4:23 PM
Clinic Address
Clinic Address 2
City, State, Zip
Source Points
Clinic Name Here
Website here/email here
Your least dominant element is Fire. The Fire Element contains the Heart, Pericardium, Small Intestine and
Triple Heater meridians. These regulate circulation, digestion, elimination, emotions, and hormone function in
the body. The fire element has the following associations:
• Sense Organ: Tongue
• Tissue: Vessels
• Taste: Bitter
• Color: Red
• Sound: Laughing
• Odor: Scorched
• Emotion: Joy
• Season: Summer
• Environment: Heat
Ratio Information
Yin vs. Yang
Your Yin/Yang energy balance is relatively equal with a slight Yin tendency of 8%.
Upper vs. Lower
Your Upper/Lower energy balance is somewhat unequal with Lower dominance of 21%.
Right vs. Left
Your Left/Right energy balance is relatively equal with a slight Right tendency of 4%.
Energy Level
Your overall level of chi energy is within the normal range (101%).
Energy Stability
Your energy stability is within low normal limits (67%), likely indicating reasonably good autonomic nervous
system balance.
Custom Treatment Recommendations
Pericardium Meridian Split, Triple Heater Meridian Deficient, Bladder Meridian Excessive:
This is where you can add any custom treatment recommendations of your own, including herbs,
acupuncture, diet, nutrition, qigong, or any other therapy. AcuGraph will automatically save and intelligently
apply your custom recommendations, based on exam findings.
Example Patient
Dr. Name Here
Clinic Phone Number / Fax number here
2/12/08 4:23 PM
Clinic Address
Clinic Address 2
City, State, Zip
Source Points
Clinic Name Here
Website here/email here
Notes
This is where you can add your own notes to any examination. Add observations, treatment ideas, or even
complete S.O.A.P. Notes. You can even copy and paste from any application. Any notes you add here will be
saved with the exam for later retrieval.
Basic Treatment
TE 3: Zhongzhu (Central
Islet)
Location:
In a depression on the back of
the hand, between the 4th and
5th metacarpals, proximal to
the MCP joint.
Attributes:
Shu-Stream, Wood and
Tonification point of the Triple
Energizer channel.
Functions:
Clears heat, benefits the ears,
clears the head and eyes,
activates the channel,
alleviates pain. Used for ear
problems, arm pain,
headache, sore throat, eye
redness, febrile diseases, and
finger paralysis, mood swings,
depression. Special for
chronic ear infections.
Example Patient
Dr. Name Here
Clinic Phone Number / Fax number here
2/12/08 4:23 PM
Clinic Address
Clinic Address 2
City, State, Zip
PC 6: Nei Guan (Inner Pass)
Location:
On the anterior forearm, 2 cun
proximal to the transverse wrist
crease, between the tendons of
palmaris longus and flexor carpi
radialis.
Attributes:
Luo point of the PC channel,
command point for the Chong
vessel. Master point for the Yin
Linking vessel.
Functions:
Unbinds the chest and regulates
Qi, harmonizes the stomach,
clears heat, opens the Yin linking
vessel. Master point for the
abdomen, used for mental
disorders, neurosis, motion or
morning sickness, chest pain,
distention/ fullness, fever, pain
along the channel.
Cautions:
The median nerve lies directly
beneath this point.
Source Points
Clinic Name Here
Website here/email here
BL 65: Shu Gu (Restraining Bone)
Location:
Posterior and inferior to the lateral head of the 5th metatarsal.
Attributes:
Sedation, wood, and Shu-Stream point of the Bladder channel.
Functions:
Used for headache, low back and leg pain, soothes the sinews,
clears heat, dissipates swelling, activates the channel,
alleviates pain.
Auricular Treatment
Point Zero
PC 6
Frequency:
10 Hz.
Frequency:
5 Hz.
Point Information:
Produces homeostatic
equilibrium and restores
energetic balance.
Point Information:
This point is the auricular
analogue to the Luo
(connecting) point on the
main meridian. It is
indicated for treatment of
split (left/right
imbalanced) meridians.
O = Non-Visible Surface
• = Visible Surface
Example Patient
Dr. Name Here
Clinic Phone Number / Fax number here
2/12/08 4:23 PM
Clinic Address
Clinic Address 2
City, State, Zip
O = Non-Visible Surface
• = Visible Surface
Source Points
Clinic Name Here
Website here/email here
TE 3
Point Zero
Frequency:
5 Hz.
Frequency:
10 Hz.
Point Information:
This point is the auricular
analogue to the
tonification point on the
main meridian. It is
indicated in the case of
meridian deficiency.
Point Information:
Produces homeostatic
equilibrium and restores
energetic balance.
O = Non-Visible Surface
• = Visible Surface
O = Non-Visible Surface
• = Visible Surface
PC 6
TE 3
Frequency:
5 Hz.
Frequency:
5 Hz.
Point Information:
This point is the auricular
analogue to the Luo
(connecting) point on the
main meridian. It is
indicated for treatment of
split (left/right
imbalanced) meridians.
Point Information:
This point is the auricular
analogue to the
tonification point on the
main meridian. It is
indicated in the case of
meridian deficiency.
O = Non-Visible Surface
• = Visible Surface
Example Patient
Dr. Name Here
Clinic Phone Number / Fax number here
2/12/08 4:23 PM
Clinic Address
Clinic Address 2
City, State, Zip
O = Non-Visible Surface
• = Visible Surface
Source Points
Clinic Name Here
Website here/email here
Associated (Back Shu)
BL 22: San Jiao Shu
(Triple Burner Shu)
Location:
1.5 cun lateral to the lower
border of the spinous process
of L1, at the highest visible
point of the paraspinal
muscles.
BL 28: Pang Guang
Shu (Bladder Shu)
Location:
1.5 cun lateral to midline
level with the second
posterior sacral foramen.
Attributes:
Back-Shu of the Triple
Energizer.
Attributes:
Back-Shu of the Bladder.
Functions:
Moves and regulates the
Triple Energizer, Regulates
the Spleen and Stomach ,
resolves dampness, regulates
the water passages, promotes
urination, resolves masses.
Functions:
Regulates the Bladder,
clears damp-heat from
the Lower Energizer,
dispels stagnation and
masses, benefits the
lumbar region and legs.
Cautions:
Deep perpendicular needling
may cause Kidney injury.
Example Patient
Dr. Name Here
Clinic Phone Number / Fax number here
2/12/08 4:23 PM
Clinic Address
Clinic Address 2
City, State, Zip
Source Points
Clinic Name Here
Website here/email here
Herbal Prescriptions
!
SP-002 SHI QUAN DA BU PIAN!
Strengthening Qi and Blood since 1110 A.D.!
!
* TCM Therapeutic Actions: Strengthens or Tonifies Qi and blood. Warms, supports
Yang, and strengthens Wei Qi.!
!
* TCM Indications: Qi and Blood deficiency with the symptoms of sallow
complexion, shortness of breath, palpitations, dizziness, spontaneous perspiration,
mental fatigue, lassitude of the extremities, profuse menstruation, sore feet or knees.!
!
* Modern Indications: Immune system deficiency, side effects of chemotherapy and
radiation, coughs, asthma, impotence.!
!
* Comments: This versatile classical formula combines two famous formulas - one
for blood; one for Qi. Together these herbal ingredients powerfully support both. This
formula can be used after heavy bleeding like excessive blood loss due to childbirth or
surgery. It can also be used after chemotherapy and radiation to reduce side effects, as
well as increase the T-cell count. In severe cases or in early stages, may increase dose
50% for a few weeks, then decrease as symptoms improve. Contra-indicated during
acute phase of illness (cold/flu). Use care in cases of abdominal bloating, loose stools,
or general digestive weakness. Take small doses of Bao He Wan (206-SP) or Xiang Sha
Liu Jun Wan (205-SP).!
!
* Recommended Usage: 2-3 tablets twice daily with warm water.