Client contract for 1st appointments (massage)

[RayeKaye]

Hi There,

I have just recently started out as a self employed mobile massage therapist and just beginning to see new clients. I am hopefully following the correct procedures so fari.e- doing the consultations, giving an aftercare advice sheet as well as verbal. Anyway it has come to my attention recently that I havent given them a Client Contract to sign, when I wastraining at college, we wasnt given much information as regards this [&:], and I heard that it is important for the therapist toprovide one, if so, in order for me to providea contractwould somebody with some experienceplease kindlyhelp me with the type of wording thatshould be usedon it.

Thankyou all in advance foryour help
Jill

 

[twirldaworld]

What you are looking at is an informed consent form.[/align][/align]They usually state that the therapist (yourself) has explained the nature of the treatment and what is expected to happen during the treatment during the consultation process, by signing this contract the recipient agrees to receive the treatment from the therapist (you).[/align][/align]On the ones that I use I have a front and back picture of either a male or female depending on who is receiving the treatment, I use this to show them areas that will probably need treating, explain how I treat and both of us sign and date it, hope that helps.[/align]

 

[Juan]

Thank you paul,
Any chance you could explain in a bit more detail about the wording of it?
I will type up today or tomorrowa sample consent form and paste it onto this thread, perhaps you wouldnt mind letting me know if it is ok.

Thanks, Jill

 

[Jfkfsjks Fsjfdsjsdfj]

Hi Jill

Should this not be on the Client Record Card that you go through during the consultation. I have a bit at the end which is their declaration of consent to having treatment done and a space for their signature and date.

At college, we had Client Record cards (provided by the Therapies department) and I have based mine on a bit on theirs.

This is what mine says at the bottom of my Client Record card - I think I got it off this forum too but can't recall:

I declare that the information I have given is correct and promise to notify the Therapist should there be any changes to my health. As far as I am aware I can undertake treatment without any adverse affects. I have been fully informed about any contraindications and am willing to proceed with the treatment.

Tracy

 

[Petrusclavus]

Hi Jill[/align][/align]I don't know if this will work but I will try and past that bit in as it is in a table?[/align][/align]




Consent form:[/b]


I. Mr Paul Crick, has done a consultation and he has explained both the nature and the form of treatment that I will be receiving which may vary depending on what is found once the treatment has commenced.
II. He has also explained that he is very happy to explain anything to me that I am not sure of.
III. Mr Crick has also explained that this consent form will cover any future treatments that I may wish to receive from him at any time in the future.
IV. By signing this form I am consenting to receive treatment from Mr Paul Crick.



Date: ______________________ Patients signature: _________________________________

Date: ______________________ Therapists signature: _________________________________
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[Alucard]

[sm=wave.gif]Hello again Pemba, hope you are well.
I think some therapist do have it written on their consultation cards, depending on how they were taught or through preference. I thinkpersonally Iwould like to have a seperate consent form written and perhaps staple it to the consultation card. I think Iwill also include a short code of care on it too.
Anyway as I mentioned to Paul I will do a sample consent form and paste it on here later, let me know though if you think its ok.
Cheers,
Jill

 

[Sam Anderson]

Hello Paul,

Thankyou for your consent form details, I very much appreciate it.
I will get cracking tomorrow and write one up, keep a look out wont you?

Jill

 

[cowgirl]

I have a questionnaire that includes medical history, lifestyle, address, phone number etc. My form also includes a list of contraindications which I ask them to read through. I also put on the form

"I have read the forgoing notes and to my knowledge I have not wihheld any information that might affect my treatment. I confirm I have read the list of contraindications and have notified the therapist of any conditions on the list. I understand that massage does not take the place of a doctors care."
Signed................................................ Date......................

Luv Binah

 

[Skully]

Hi Binah[/align][/align]I have the consultation sheet on the other side from my informed consent form which covers recent serious illnesses, operations and such is the like.[/align][/align]I don't have many contraindications, so I usually pick up anything during the consultation, once I have finished the consultation and explained the nature of the treatment, I asked them if they have any questions they would like to ask me, I then get them or a guardian in the case of a minor to sign what I put above, before I will give them a treatment.[/align]

 

[sagsspeeliday]

Hi Guys,
Thankyou for your help. I have pasted below a sample of my consent form as mentioned.
Please let me know what you think or advise of anything i may ofnot haveincluded/missed out or shouldnt include, Ta!
Jill


Client Consent Form

I have completed a consultation form and declare that the information given is correct and I will inform the massage therapist of any changes to this information.
I understand that massage therapy is a safe treatment, and that if I have an illness that is contra-indicated to massage, I or the therapist will seek my GPs consent.
I understand that massage therapy is not a substitute for conventional medical treatment. And the massage therapist cannot assume to diagnose any symptoms or prescribe any medication.
I understand it is important for me to inform the massage therapist during massage sessions if I experience any unusual pain or discomfort.
I understand I can undertake treatments without any adverse effects, The massage therapist has explained and informed me about contra-indications.
I understand that 24 hours notice is required for cancellation of appointments, otherwise a full payment of the time of treatment booked will be required.
I wish to proceed with the massage treatment.

Signed …………………………………………………………
Print name……………………………………………………...
Date ……………………………………………………

Disclaimer (if applicable)

I confirm that I have understood the massage treatment I am to receive and confirm that I am willing to proceed without confirmation from my GP.

Signed …………………………………………………………………….
Print name………………………………………………………………
Date ……………………………………………………

Private Policy/Code of Care

·All information disclosed during and after consultations will under no circumstances be revealed to any other persons inside or outside my profession, (except in circumstances where I may need to gain medical consent from your GP. Or if there is suspicion of harming yourself or others, child abuse or terrorism).
·Client records are kept in a file and locked in a safe place.
·Clients modesty will be maintained at all times by the covering of towels except the area that is being worked over.
·If you are receiving treatment for a medical condition from your GP, hospital or other practitioners, it is recommended if you consider it appropriate to inform all parties concerned that you are receiving massage treatment.
·You will be treated with care and respect at all times.
·I the therapist will try to help and answer any questions that you may have regarding your treatments.

Signed (Therapist)………………………………………………………………

Print name……………………………………………………………………...

Date………………………………………………………….








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