Massage intake and consent formclear on what massage is
A massage consent is mostly about two things: that massage is for relaxation and well-being, not medical treatment, and which conditions mean you should not massage that day. This template says both in plain language.
Massage consent
The same wording clients sign in Luvira. Copy it and adapt it to your services and your state.
Massage consent
Massage is provided for relaxation and well-being. It does not replace medical or physical therapy treatment.
Possible reactions: temporary muscle soreness, tenderness, light-headedness and occasional tiredness afterwards. Allergic reactions to oils are possible.
We do not massage with a fever, acute inflammation, fresh injuries, blood clots, open skin or contagious skin conditions. If you are pregnant or have a heart or circulatory condition, please tell us before your session.
Tell us at any time during the session if the pressure is too strong — massage should not hurt.
Aftercare: drink plenty of water, give your body some rest, and avoid intense exercise right after.
Please contact us if anything feels unusual after your treatment — strong pain, lasting redness, swelling or signs of infection. The sooner we know, the easier it is to help.
We cannot guarantee a specific result: skin, hair and healing differ from person to person. We work to the best of our professional knowledge and have explained the procedure, risks and alternatives to you. You had the opportunity to ask questions, and your questions were answered.
Questions to add to your intake form
Do you have a fever, an infection or a contagious skin condition today?
Have you had surgery, an injury or a blood clot in the past months?
Are you pregnant, and if so, how far along?
Do you have high blood pressure or a heart condition?
Are there areas you do not want massaged?
Are you allergic to any oils, lotions or scents?
Relaxation, not therapy
Unless you are working as part of a medical treatment plan, a massage consent should say plainly that massage is for relaxation and does not replace medical care. It sets expectations and keeps the therapist on the right side of what a massage license covers in most states.
Contraindications and comfort
Fever, fresh injuries, blood clots and contagious skin conditions are reasons not to massage at all. Pregnancy and heart conditions are reasons to adjust. The questionnaire should ask about each — and also about areas the client does not want touched, which is about comfort as much as safety.
The consent also tells the client to speak up about pressure. Saying it in writing makes it easier for a quiet client to say it in the room.
Template, not legal advice. Consent requirements differ by state and by service — check your state board’s rules and have the wording reviewed before you use it.
More for massage
Other specialties
Frequently asked questions
About consent forms for massage
Requirements vary by state and by setting. Most therapists use an intake form anyway, because contraindications have to be known before the session.
The template asks clients to tell you when anything changes. Many therapists also ask a short check-in question at each visit.
Not yet. The forms in Luvira use fixed wording today. Use this page to copy the template and adapt it if you need extra questions.
A template is not compliant or non-compliant by itself. If HIPAA applies to your practice, store forms in a system that supports it; Luvira makes no HIPAA claim.
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