Massage Informed Consent and Intake Form
This file includes a massage informed consent and intake form to ensure client understanding and communication of their health status. It is essential for anyone seeking massage therapy to complete this form accurately. Therapists use the information to tailor their services to individual needs.
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How do I fill this out?
Filling out this form is essential for ensuring a safe and effective massage experience. Take your time to complete each section accurately. Your therapist will review the information with you to clarify any questions.
How to fill out the Massage Informed Consent and Intake Form?
1
Read the instructions carefully before beginning.
2
Fill in your personal information in the designated fields.
3
Provide accurate medical information and history.
4
Indicate your preferences for the massage session.
5
Sign and date the form to confirm your consent.
Who needs the Massage Informed Consent and Intake Form?
1
Individuals seeking massage therapy for relaxation.
2
Patients undergoing treatment for chronic pain.
3
Athletes requiring recovery massages.
4
First-time massage clients who need guidance.
5
Healthcare providers referring patients for massage therapy.
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What are the instructions for submitting this form?
Submit the completed form to your therapist via email at therapist@example.com, fax it to (555) 123-4567, or bring it in person to the clinic. Ensure the form is filled out completely to avoid delays. If you have any questions, reach out before your appointment.
What are the important dates for this form in 2024 and 2025?
Please make sure to submit your consent and intake form at least 24 hours before your scheduled appointment. Any changes to your medical history should be reported to your therapist as soon as possible. This will ensure a smooth and effective treatment process.
What is the purpose of this form?
The purpose of this form is to ensure that both the client and the therapist understand the client’s medical history and consent to the massage therapy. It serves as a safeguard for the client, informing them of their rights and the nature of the therapy they are about to receive. By signing this form, clients acknowledge their responsibility to provide accurate health information.
Tell me about this form and its components and fields line-by-line.
- 1. Name: The full name of the client.
- 2. Pronouns: Client's preferred gender pronouns.
- 3. Phone: Client's contact information.
- 4. DOB: Date of birth of the client.
- 5. Gender Identity: Client's current gender identity.
- 6. Medical Conditions: Client's known medical conditions.
- 7. Massage Experience: Client's prior experience with massage.
- 8. Treatment Goals: Client's goals and expectations for the session.
What happens if I fail to submit this form?
If you fail to submit this form, it may delay your appointment and limit the therapist's ability to provide appropriate care. Incomplete forms may result in additional questions during your appointment, affecting the overall experience.
- Incomplete Information: The therapist may not have all the necessary information to provide care.
- Delayed Service: Failure to submit on time can affect your scheduled appointment.
- Lack of Consent: Without submission, the therapist cannot confirm your consent for treatment.
How do I know when to use this form?
- 1. First-time Clients: New clients must complete the form for safety and understanding.
- 2. Existing Clients with Changes: Clients returning with updated health conditions should fill out the form again.
- 3. During Assessments: Therapists may require updates in client information periodically.
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