Massage Therapy Consent Form

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A message therapy consent form is signed by a new client to provide written authorization for a massage therapist to perform treatment. By completing this consent form, the client confirms their understanding of the treatment process, acknowledges the potential risks, and agrees not to hold the massage therapist liable if they experience pain or discomfort.

Massage Therapy Consent Form

A message therapy consent form is signed by a new client to provide written authorization for a massage therapist to perform treatment. By completing this consent form, the client confirms their understanding of the treatment process, acknowledges the potential risks, and agrees not to hold the massage therapist liable if they experience pain or discomfort.

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Last updated October 21st, 2024

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A message therapy consent form is signed by a new client to provide written authorization for a massage therapist to perform treatment. By completing this consent form, the client confirms their understanding of the treatment process, acknowledges the potential risks, and agrees not to hold the massage therapist liable if they experience pain or discomfort.

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Minor Massage Therapy Consent Form – If the client (patient) is a minor, this consent form should be signed by the child’s parent or legal guardian.

 

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Obtaining informed consent for massage therapy is an essential step in the treatment process. It ensures clients understand the risks and benefits of massage therapy, while also legally protecting the massage therapist in case of injury or other complications.

Although the requirements for obtaining informed consent differ based on each state’s laws and professional regulations, the process typically starts with a conversation where the massage therapist explains:

  • The nature of the treatment – Including the different massage techniques and expected benefits.
  • The risks and common side effects – Bruising, temporary muscle soreness, etc.
  • Alternatives – Other treatments the client might prefer based on their condition and comfort level.

After discussing the above, the massage therapist should address any questions or concerns and ensure the client understands the details provided. The client can then sign a consent form to authorize the massage treatment.

Sample

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MASSAGE THERAPY CONSENT FORM

Massage Facility: [FACILITY’S NAME] Massage Therapist: [THERAPIST’S NAME]

By signing below, I agree to the following:

1. I voluntarily request and consent to receiving massage therapy.
2. I understand that the massage service offered is for the purposes of general wellness, stress reduction, and relief of muscular tension only.
3. I do not have any injuries or conditions that prevent me from receiving massage therapy. I understand the importance of informing my massage therapist of all medical conditions and medications that I am taking, and that there may be additional risks based on my physical condition.
4. If I experience any pain or discomfort, I will immediately inform my therapist so that the pressure or techniques used can be adjusted to my comfort level. I will not hold my massage therapist responsible for any pain or discomfort I experience during or after the session.
5. I understand the risks associated with massage therapy include, but are not limited to, superficial bruising, short-term muscle soreness, and exacerbation of undiscovered injury.
6. I do not have any contagious conditions that may put my massage therapist or other clients at risk.
7. I understand that I or the massage therapist may terminate the session at any time.
8. I have been given the opportunity to ask questions about massage therapy and my questions have been answered.

I have been advised of the policies and procedures pertaining to massage and I understand these policies. Information regarding massage in general, benefits, contraindications of massage, and possible alternative therapies have been explained to me. I further understand that massage therapy is not a substitute for a medical examination or treatment, and that I should see a physician or other qualified health specialist for any mental or physical ailment of which I am aware. I understand that massage therapists do not diagnose illness or disease, and nothing said during the massage should be construed as such. My consent is informed and voluntary and I understand that I may withdraw my consent at any time except for actions already taken.

By signing this form, I give my consent to proceed with the massage service as outlined above.

Client Signature: _____________________________ Date: ________
Printed Name: _____________________________