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Massage Client Intake Form
"I need a Massage Client Intake Form Free for my new wellness center in Singapore that includes comprehensive medical history collection and specific sections for sports injuries, as we'll be working primarily with athletes and need to ensure proper documentation for insurance purposes."
1. Personal Information: Client's basic contact details including name, address, phone, email, emergency contact, and identification details as required by Singapore regulations
2. Medical History: Comprehensive health information including current conditions, medications, allergies, surgeries, and previous injuries in compliance with Healthcare Services Act requirements
3. Consent Declaration: Client's explicit acknowledgment and agreement to treatment, including PDPA-compliant data collection consent
4. Privacy Notice: Detailed explanation of how personal information will be collected, used, and protected in accordance with Singapore's Personal Data Protection Act
1. Pregnancy Information: Additional health information and considerations for pregnant clients or those who may be pregnant, including trimester, due date, and pregnancy-related conditions
2. Sports/Exercise History: Detailed information about physical activities, training regimens, and sports-related concerns for athletic clients
3. Pain Assessment: Comprehensive evaluation of pain locations, intensity levels, and patterns for therapeutic massage purposes
1. Treatment Consent Form: Detailed consent form outlining specific treatments, risks, and client acknowledgments in compliance with Singapore healthcare regulations
2. Body Chart: Anatomical diagram for marking areas of concern, pain, or specific treatment requirements
3. Service Price List: Current pricing schedule for various massage services in compliance with Consumer Protection (Fair Trading) Act requirements
Authors
Client
Massage Services
Treatment
Personal Information
Medical History
Consent
Contraindications
Confidential Information
Treatment Session
Medical Condition
Emergency Contact
Health Information
Treatment Plan
Privacy Notice
Liability
Therapeutic Massage
Pre-existing Conditions
Treatment Area
Professional Services
Medical History
Health Conditions
Emergency Contact Information
Consent and Authorization
Privacy and Confidentiality
Liability Waiver
Health and Safety Declarations
Service Acknowledgment
Treatment Preferences
Previous Injuries
Current Medications
Allergies and Sensitivities
Pregnancy Status
Pain Assessment
Medical Referral Information
Cancellation Policy
Photo/Video Consent
Data Protection
Release of Information
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