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Massage Therapy Patient History PLEASE PRINT CLEARLYTodays Date: Patient Number: Name: Preferred Name: Address: City: State: Zip: Home Phone: Cell Phone: Work Phone: Date of Birth: Age: SSN: Gender:
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How to fill out massage formrapy patient history

01
To fill out a massage therapy patient history form, follow these steps:
02
Start by providing your personal information, such as your name, date of birth, and contact details.
03
Include your medical history, including any past injuries or surgeries.
04
Specify any current medical conditions or medications you are taking.
05
Mention any allergies or sensitivities to certain products or substances.
06
Describe your reason for seeking massage therapy and any specific goals or concerns you may have.
07
Indicate your previous experience with massage therapy or other alternative treatments.
08
Provide information about your lifestyle and activities, including exercise routines or any physically demanding work.
09
Mention any areas of the body that require particular attention or any areas to avoid.
10
If applicable, include details about your insurance coverage or payment preferences.
11
Finally, sign and date the form to indicate your consent and understanding of the information provided.

Who needs massage formrapy patient history?

01
Massage therapy patient history forms are needed by individuals who are seeking massage therapy services.
02
These forms help massage therapists gather important information about their clients' medical history, current health status, and treatment goals.
03
This information is essential for the massage therapist to assess the individual's needs, tailor the massage treatment accordingly, and ensure client safety.
04
Massage therapy patient history forms are commonly used in spas, wellness centers, rehabilitation clinics, and private massage therapy practices.
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Massage therapy patient history is a record of a patient's medical information, physical condition, and any previous massage therapy treatments.
Massage therapists are required to file the patient history before starting any treatment.
The therapist will typically ask the patient to fill out a form detailing their medical history, current complaints, and any prior injuries or surgeries.
The purpose of the patient history is to provide the therapist with important information to tailor the treatment to the patient's specific needs and ensure their safety.
Information such as medical conditions, medications, allergies, previous injuries, and areas of pain or tension should be reported on the patient history form.
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