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Northwest Family Chiropractic Massage Health History Form Name: Date: / / Address: City/State/Zip: What is the best Phone number to call?: () DOB: / / Email: How were you referred? Insurance Internet
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How to fill out massage health history

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How to fill out massage health history:

01
Start by providing your personal information, including your full name, date of birth, address, and contact details.
02
Next, mention any current or past medical conditions, such as allergies, heart problems, respiratory issues, or any chronic illnesses.
03
Indicate any surgical procedures you have undergone along with the dates and outcomes.
04
Include information about any medications or supplements you are currently taking, including dosage and frequency.
05
Mention any previous or ongoing injuries, such as fractures, sprains, or muscle strains, and note the dates and treatments received.
06
Provide details about your general health and lifestyle habits, including your exercise routine, diet, smoking or drinking habits, or any other relevant information that may impact your massage treatment.
07
Mention any specific areas of concern or reason for seeking massage therapy, such as back pain, tension headaches, stress relief, or relaxation.
08
If you have any preferences or restrictions regarding massage techniques, pressure intensity, or any other specific requests, make sure to mention them.
09
Finally, don't forget to sign and date the health history form, acknowledging that the information provided is accurate to the best of your knowledge.

Who needs massage health history?

01
Anyone seeking professional massage therapy should fill out a health history form.
02
It is essential for the massage therapist to have a comprehensive understanding of the client's health background to ensure their safety and provide appropriate treatment.
03
Whether you are a first-time client or a regular recipient of massage therapy, maintaining an updated health history helps the therapist assess your individual needs and tailor the session accordingly.
04
The information provided in the health history form allows the massage therapist to identify any contraindications or precautions that should be considered during the treatment.
05
By filling out the health history form, you actively contribute to your own well-being and help create a safe and effective massage experience.
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Massage health history is a record of important medical information related to a client's health and well-being that may impact their massage therapy treatment.
Any individual receiving a massage therapy treatment is typically required to provide a massage health history.
Massage health history forms can usually be filled out by hand or electronically, and should include information such as medical conditions, medications, and any injuries.
The purpose of massage health history is to ensure the safety and well-being of the client during the massage therapy session by providing the therapist with pertinent medical information.
Information such as medical conditions, medications, allergies, injuries, and any previous surgeries should be reported on a massage health history form.
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