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Massage Therapy Consultation Form

Massage Therapy Consultation Form Template for India

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Massage Therapy Consultation Form

"I need a Massage Therapy Consultation Form for my new wellness center in Mumbai, compliant with Indian healthcare regulations, that includes detailed medical history sections and can be used by multiple therapists, with both English and Hindi versions."

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Document background
The Massage Therapy Consultation Form is a fundamental document required for all professional massage therapy services in India. It serves as a comprehensive intake tool that combines medical screening, informed consent, and legal protection elements. This document is essential for compliance with Indian healthcare regulations, including The Clinical Establishments Act and AYUSH guidelines. The form must be completed before initiating any massage therapy treatment and includes detailed sections for client information, medical history, contraindications, and treatment consent. It helps practitioners assess client suitability for treatment, document health conditions, and maintain proper medical records while protecting both the practitioner and client through clear liability and privacy provisions.
Suggested Sections

1. Personal Information: Client's basic details including name, contact information, date of birth, occupation, and emergency contact details

2. Medical History: Comprehensive health history including current medications, surgeries, injuries, and chronic conditions

3. Current Health Status: Present health concerns, symptoms, pain levels, and areas requiring attention

4. Massage History: Previous massage experience, preferences, and any adverse reactions

5. Contraindications Assessment: Specific conditions that may affect treatment, including cardiovascular issues, skin conditions, and recent injuries

6. Treatment Consent: Client's acknowledgment and consent for massage therapy treatment

7. Privacy Policy: Information about how client data will be collected, stored, and protected

8. Liability Waiver: Legal disclaimer and limitation of liability

9. Client Signature: Space for client signature, date, and therapist signature

Optional Sections

1. Pregnancy Information: Additional section for pregnant clients, including trimester, due date, and pregnancy-specific concerns

2. Sports/Activity Information: For clients seeking massage related to sports or specific physical activities

3. Post-Surgery Recovery: Additional details for clients recovering from surgery

4. Pain Assessment Diagram: Body diagram for marking areas of pain or concern

5. Treatment Goals: Client's specific goals and expectations from the massage therapy

6. Insurance Information: For clients seeking insurance coverage or reimbursement

Suggested Schedules

1. Body Chart: Anatomical diagram for marking areas of concern, pain, or specific treatment requirements

2. Treatment Plan: Detailed plan showing recommended session frequency and focus areas

3. Contraindications List: Comprehensive list of conditions that may affect treatment

4. Aftercare Instructions: Post-treatment care guidelines and recommendations

5. Price List: Current service rates and package options

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈË°æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co
Relevant legal definitions

























Clauses




















Relevant Industries

Healthcare

Wellness and Spa

Alternative Medicine

Sports and Recreation

Hospitality

Medical Tourism

Rehabilitation Services

Occupational Health

Relevant Teams

Operations

Medical Records

Compliance

Legal

Customer Service

Wellness

Clinical Administration

Risk Management

Quality Assurance

Front Desk

Relevant Roles

Massage Therapist

Physical Therapist

Wellness Coordinator

Spa Manager

Healthcare Administrator

Medical Records Officer

Rehabilitation Specialist

Alternative Medicine Practitioner

Sports Therapist

Clinical Director

Compliance Officer

Risk Management Specialist

Industries






Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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