Printable Massage Therapy Consent Form Template

Important Client Consent

This document serves as an example template for obtaining informed consent before massage therapy sessions. It is designed for general informational purposes and should be customized to meet specific legal and professional standards. It does not replace the advice of a qualified healthcare provider or legal expert. Users are responsible for ensuring compliance with applicable laws and regulations in their jurisdiction. The example provided is for illustration only and the creator assumes no liability for its use without proper review and adaptation.

This sample template of a Massage Therapy Consent Form outline is provided for general informational purposes and may vary based on specific requirements and regulations. Adjust details accordingly.

Printable Massage Therapy Consent Form Sample

Parties Involved:

Therapist: Emily Johnson
Business Name: Serenity Massage Clinic
Address: 789 Wellness Drive, Springfield, IL 62704

Client: Michael Brown
Address: 1010 Maple Street, Springfield, IL 62704

Description of Services:

The therapist will provide massage therapy services, including techniques such as Swedish, deep tissue, and relaxation massage, tailored to the client’s needs and preferences.

Consent and Agreement:

The client understands and agrees that massage therapy may involve physical contact and that they should communicate any discomfort during the session. The client affirms that they have disclosed all relevant medical information and are responsible for informing the therapist of any health issues or concerns.

Health and Medical Conditions:

The client agrees to notify the therapist of any allergies, medical conditions, or injuries prior to the session. The therapist is not liable for any adverse reactions if such information is not disclosed.

Waiver of Liability:

The client releases the therapist and the clinic from any liability arising from the massage therapy services, provided that the services are performed professionally and with reasonable care.

Additional Notes:

• The client agrees to follow pre- and post-session instructions provided by the therapist.
• Payments for services are due at the time of the appointment.
• This consent form is valid for the current session only and may be renewed or updated in subsequent appointments.

Springfield, ______________________