This form does not constitute professional or legal advice, and AMTA makes no warranty or representation that it is accurate, complete, or suitable for any specific purpose. Each therapist must use their own independent judgment and consult local and state regulatory authorities for the most up-to-date requirements. If you're ready to take your client documentation off the page and into the cloud, check out ClinicSense , a complete practice management software package.
Learn More About ClinicSense. Use this sample letter to introduce yourself and share your qualifications with healthcare providers. Although there are varieties of massage intake forms that highly depend on the expertise and specializations of the massage therapy center, there are certain contents of a massage intake form that should be kept and be included regardless of its variety.
Below are five significant sections found in any massage intake form:. The information stated in this section must not be disclosed to any third party and must be used limitedly for the purpose of designing an effective or suitable program for the client. This is the section where the current and previous illnesses of the client are indicated.
The client must state his medical condition which includes allergies, seizures, and infectious diseases. These details will assure the therapist that the condition of the client will not worsen in the duration and after the session.
Other inclusions in this section are the indication of the client of whether she is trying to conceive or be pregnant, and the list of medications that the client is taking prescribed by a licensed physician. You may also check out career counseling forms.
The reasons why the client wants to obtain the massage services are stated in this section. Details about the exercise programs that the client has, his injuries, and his sought-after therapies must also be included to guide the therapist. You may also see therapy consent forms. The purpose of an acknowledgment statement is to obtain an understanding between the massage center and the client.
The acknowledgment focuses on the guarantee of the center, the general schedules , and the discussions that the parties have disclosed for the success of the treatment. This last section is essential to inform the client about his responsibilities regarding his health and medical conditions which should be disclosed properly to the massage therapist.
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