A massage consultation form is a document that a massage therapist uses to gather information about a client's medical history, current health conditions, and massage preferences. This form helps the massage therapist determine the most appropriate massage techniques to use and any areas of the client's body to avoid during the massage.
The form may include questions about:
- The client's medical history
- And any areas of pain or discomfort.
It may also ask about the client's preferred pressure level, massage oil or lotion preferences, and any areas of the body they would like the therapist to focus on or avoid.
The Importance of the Massage Consultation Form and the Massage Client Record Card
Forms and record cards before, during and after massage treatment are crucial for several reasons:
#1. Medical history
Client intake form allows the massage therapist to collect detailed information about the client's health history, areas of concern, and any injuries or chronic conditions they may have.
Experienced massage therapists always keep survey cards of their patients. In such questionnaires, it is convenient to identify the problems with which a person came to the session. In addition, it is convenient to track the dynamics of the patient's health status and note which courses were conducted.
At Medesk, information about each patient is stored in an individual electronic medical record. It allows you to continuously monitor the process of his treatment.Open the description >>
#2. Developing a treatment plan
The information gathered on the form helps the massage therapist develop a customized treatment plan that is tailored to the client's specific needs and goals.
For example, if a client has a history of lower back pain, the therapist can use the information on the form to develop a treatment plan. This includes specific massage techniques to target that area of the body. Alternatively, if a client is experiencing stress and tension in their neck and shoulders, the therapist will focus on relaxation techniques and muscle release in those areas.
Every decent body massage consultation form contains a body chart. The specialist uses it to mark pain areas according to the patient. The SIN factor, meaning severity, irritability and nature of pain are also mentioned. It helps to visually understand the correlation between current medical conditions.
#3. Recording progress
The form also serves as a record of the client's progress over time and can be used to track changes in their health or any improvements in their condition.
By keeping a record of the client's progress, the therapist can adjust the treatment plan accordingly and ensure that the massage is effective. Additionally, the progress documented on the form can help inform future sessions and ensure that the client's needs are being met.
#4. Contraindications and client consent form
The client consultation form helps to ensure that the massage therapist is aware of any contraindications or precautions that need to be taken during the massage. This includes avoiding certain areas of the body or adjusting the pressure used during the massage.
Client signature on the informed consent is vital because it establishes a clear and mutually agreed-upon understanding between the client and the therapist about the type of massage that will be performed, the areas of the body that will be addressed, and any limitations or precautions that need to be taken.
Without consent, a therapist may perform a massage that the client is not comfortable with, potentially causing harm or creating a negative experience. Consent also ensures that the client is fully informed about the risks and benefits of the massage.
#5. Liability release
A liability release is a crucial component of a massage form. This is because it protects the massage therapist or business from potential lawsuits in case a client experiences injury or harm during the massage session. It is a legal document that the client signs to acknowledge that they are aware of the risks associated with therapy. In addition, they release the therapist from any legal liability in case of injury or harm.
The liability release typically includes information about the client's medical history, any pre-existing conditions, and the client's agreement to receive massage therapy at their own risk. Overall, including a liability release in the massage form is essential for both the therapist and the client to protect their rights and interests.
Ultimately, client consent helps to build trust and respect between the therapist and client, and promotes a safe and effective massage therapy experience.
Massage Consultation Form Template
Conventionally, any massage intake form can be divided into three parts – personal details, medical (massage) information and conclusion (privacy notice, signatures). You can make them up yourself, or use ready-made templates and forms in our practice management software.
First, the patient must specify his full name and contact details. Remember that not everyone is ready to leave their phone number, so you can make a note that this is not necessary.
Client details must include date of birth, address, height, weight and occupation. It is sometimes advisable to include an emergency contact with a patient's relationship.
Previous medical history
Following that, ask the patient to mark "yes" or "no" next to each transferred and existing disease. For example:
- Heart failure
- High blood pressure
- Low blood pressure
- Rapid blood clotting
- Bronchial asthma
- Osteoporosis and so on.
Next, you need to ask the client if he is taking medications. If so, which ones? It is necessary to find out about injuries to the spine or limbs, and ask about the general well-being of the patient, his mood. Select contraindications in a separate block:
- Any blood diseases
- Cancer at any stage
- Tuberculosis in the open form
- Vascular diseases (thrombosis, angiitis, vascular fragility, aneurysms, vascular atherosclerosis)
- Burger's disease, varicose veins in the area of the lesion
- Mental illness
- Infectious diseases
- Elevated temperature
- Inflammatory processes
- Acute renal, hepatic, and heart failure
- Skin diseases of a bacterial, viral, fungal, autoimmune, allergic nature
- The presence of inflammatory processes in internal organs and the dermis (purulent wounds)
- Furunculosis, pustular rash, at the massage site
- Inflammation of the lymph nodes and blood vessels
- High and low blood pressure, hypertensive and hypotonic crises, heart attacks, strokes
- Symptoms of food poisoning and gastrointestinal infections (nausea, vomiting, diarrhea)
- Taking alcohol, drugs, or psychotropic substances
When compiling the questionnaire, try to make the questions simple and understandable. No need to use complex words and constructions. Questions should be polite.
Clients may have preferences regarding the amount of pressure applied and the specific techniques used during the session. Some clients prefer a lighter touch, while others prefer deep tissue work that targets specific areas of tension. Additionally, clients may have certain areas of the body they want the therapist to focus on or avoid.
Including questions related to a client's preferred massage pressure and techniques in the consultation form allows the therapist to tailor the session to the client's needs and preferences. This can help ensure a more positive and effective massage experience for the client.
Examples of such questions are as follows:
Have you had a professional massage before?
What type of massage do you prefer?
What pressure do you prefer?
What areas don’t you want massaged?
Privacy notice and signature
The sections on consent to treatment and liability release, as well as signature and date, help protect both the client and the massage therapist.
The consent to treatment and liability release section typically outlines the scope of the massage therapist's practice. This section also typically includes a waiver of liability. This means that the client agrees not to hold the massage therapist responsible for any injuries or negative outcomes that may result from the massage.
The signature and date section is where the client confirms that he has read and agrees to the information provided in the consultation form. This signature serves as evidence that the client has given informed consent for the massage treatment and has acknowledged the potential risks and benefits of massage therapy. The date is significant for tracking the timing of the consultation and any subsequent treatments, and for legal purposes in case of any disputes or claims.
You can make this section more pleasant for a client to fill by formulating it with a sincere intention like:
“I’m happy for you to...“
Electronic health records (EHR) can be useful in maintaining and updating massage consultation forms. Instead of relying on paper records, which can be misplaced or lost, EHR can securely store and organize all patient data, including their massage consultation form. It can also make it easier for therapists to access and update this information during follow-ups.
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A thorough and detailed massage consultation form is an essential tool for massage therapists. By taking the time to properly document client information and obtain consent, massage therapists can provide a safe and effective massage experience that promotes relaxation, wellness, and healing.