Massage Client Intake Form Generator for the USA

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Key Requirements PROMPT example:

Massage Client Intake Form

"I need a HIPAA-compliant Massage Client Intake Form for my new wellness center opening in March 2025, with special emphasis on sports massage and physical therapy documentation requirements."

Document background

The Massage Client Intake Form is a crucial document required for all new massage therapy clients in the United States. This form serves as both a legal document and a clinical tool, gathering essential information about the client's health history, current conditions, and treatment preferences. It ensures compliance with HIPAA privacy regulations and state-specific massage therapy practice requirements. The form must be completed before the first treatment session and updated periodically or when significant changes in health status occur. It includes sections for personal information, medical history, informed consent, and specific treatment preferences, creating a foundation for safe and effective treatment while protecting both the practitioner and client through proper documentation and clear communication of policies.

Suggested Sections

1. Personal Information: Basic client contact details including name, address, phone, email, emergency contact, and preferred method of contact

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

3. Current Health Status: Present health concerns, areas of pain/discomfort, stress levels, and current symptoms

4. Massage Preferences: Preferred pressure, areas to focus on or avoid, sensitivity to oils/lotions

5. Informed Consent: Clear explanation of massage therapy services, potential risks, and client's acknowledgment and agreement

6. Privacy Policy: HIPAA-compliant statement about how client information will be collected, used, and protected

7. Cancellation and Payment Policy: Terms regarding cancellations, no-shows, payment methods, and fees

Optional Sections

1. Insurance Information: Section for insurance details when massage is covered by health insurance or worker's compensation

2. Physician Release: Additional authorization section when client has specific medical conditions requiring physician approval

3. Pregnancy Information: Specific section for pregnant clients including trimester, due date, and pregnancy-related conditions

4. COVID-19 Screening: Temporary section for pandemic-related health screening and protocols

5. Minor Consent: Additional consent section when the client is under 18, requiring parent/guardian authorization

Suggested Schedules

1. Pain and Discomfort Diagram: Body diagram where clients can mark areas of pain, tension, or injury

2. Medical Conditions Checklist: Detailed checklist of common medical conditions and symptoms

3. Consent for Specific Treatments: Additional consent forms for specialized treatments like deep tissue or hot stone massage

4. Client Rights and Responsibilities: Detailed explanation of client rights, responsibilities, and facility policies

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 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

Physical Therapy

Sports Medicine

Hospitality

Medical Tourism

Rehabilitation Services

Relevant Teams

Operations

Clinical Services

Wellness

Compliance

Front Desk

Medical Records

Risk Management

Client Services

Administrative Services

Relevant Roles

Massage Therapist

Physical Therapist

Wellness Center Manager

Spa Director

Healthcare Administrator

Medical Records Coordinator

Compliance Officer

Risk Management Specialist

Front Desk Coordinator

Practice Manager

Clinical Director

Occupational Therapist

Sports Medicine Specialist

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Electronic Intake Forms

Legal framework for electronic intake forms compliant with US federal and state regulations, governing digital information collection and processing.

How a Sales & Marketing Lead uses Genie AI to reduce contract drafting time by 95%

Let's create your Massage Client Intake Form

Authors

Alex Denne

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