The practice of acupuncture shall not be performed upon any person except with the voluntary and informed consent of such person. Information provided in connection with obtaining such informed consent shall include, but not be limited to, the following:
(1) The distinctions and differences between the practice of acupuncture and the practice of medicine;
(2) The disclosure that an acupuncturist is not licensed to practice medicine or to make a medical diagnosis of the person's disease or condition and that a physician should be consulted for such medical diagnosis;
(3) The nature and the purpose of the acupuncture treatment; and
(4) Any medical or other risks associated with such treatment.