The Massage Consent Form is a critical legal document used in the United States healthcare and wellness industry to establish informed consent between massage practitioners and their clients. This document is essential for compliance with state massage therapy practice acts, HIPAA regulations, and professional liability requirements. The form should be completed before initiating any massage therapy services and includes detailed client health information, service specifications, risk acknowledgments, and privacy agreements. It serves as both a legal protection mechanism and a communication tool, ensuring that clients are fully informed about the treatment they will receive. The document must be regularly updated to reflect changes in state regulations and healthcare practices, particularly in response to evolving healthcare standards and privacy requirements.

1. Client Information: Basic details about the client including full name, date of birth, contact information, and emergency contact

2. Health History: Client's relevant medical history, current medications, injuries, and conditions that may affect massage therapy

3. Service Details: Description of massage therapy services being provided, including type and duration

4. Risks and Benefits: Clear explanation of potential benefits and risks associated with massage therapy

5. Client Rights and Responsibilities: Outline of client's rights during treatment and their responsibilities regarding disclosure of health information

6. Therapist Policies: Professional boundaries, draping policies, and right to refuse or modify treatment

7. Privacy Statement: HIPAA compliance statement and how client information will be protected and used

8. Consent Declaration: Formal statement of consent, including client acknowledgment of understanding and agreement

9. Signatures: Space for client signature, date, and therapist signature