consent forms

[Pink Taco]

Does anyone have a copy of a consent form I could use to take to may on-site calls? I am just getting back into the field after taking a break to raise a family, and cannot find all my old paperwork. Also...I need to purchase liability insurance. any ideas? I just read AMMA's press release about the problem of inflating prices with some of the big organizations.Thanks!

 

[Georgina.]

consent forms

I found a simple form from the ABMP members site.

Also here are two links for one of many useful forms including a form for chair massage.

http://www.sohnen-moe.com/formfiles/seat_mas.pdf
http://www.sohnen-moe.com/forms.php

 

[pomi]

Here's a sample: Please complete this confidential form to assist the massage therapist in providing a specialized seated massage. Name: Male/Female Address: Date of Birth: In Case of Emergency: Have you recieved massage before? Are you currently being treated by a physician for any condition? If yes, please explain: Recent illness/injury/surgery (please explain): Previous broken bones: Please check all applicable medical conditions we should know about: Currently pregnant Herniated disc High blood pressure Arthritis Osteoporosis Sciatica Whiplash Allergies Rashes Frequent Headaches Varicose Veins Coneforum.xxxious disease Cardiac or Circulatory problems Epilepsy or seizures Fainting spells Bruise easily Diabetes Cancer Asthma Other: Please list any medications you are taking (including non-prescription drugs): Do you have any areas of tension you would like focus work on? Then of course the standard...... If at any time during the session you feel pain or discomfort, please inform the therapist so that the massage may be adjusted to your needs. And the consent.... I consent to the massage therapy services I am receiving through (insert name of company).  The part about not diagnosing would go here as well, and something regarding an affirmation that the medical information provided was correct.  Also, a sexual clause with some info that if any inappropriate gestures or remarks are made, the session will be terminated and the client will be liable for payment of the scheduled appointment. Client Signature: Date: Hope that helps.