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COVID-19 Patient Intake Consent For Registered Massage TherapyPart 1: COVID-19 Assessment Survey: Yes / No Yes / No Yes / Mohave you or your close contact been tested for COVID-19? If Yes, is the
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Open the form on your device or print it out.
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Start with personal information such as your name, contact details, and date of birth.
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Continue by providing your medical history, including any past injuries, surgeries, or chronic conditions.
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Indicate any medications you are currently taking and allergies you may have.
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Mention specific areas or conditions you would like the massage therapist to focus on or avoid.
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Sign and date the form to acknowledge that the information provided is accurate and complete.
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Submit the form to the massage therapist or the designated recipient.
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Note: Make sure to read the form carefully and answer all the questions accurately for the therapist to provide appropriate treatment.

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Clients who have specific health issues, injuries, or chronic conditions can benefit from filling out this form to ensure that the massage therapist can tailor the treatment accordingly.
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It also helps the massage therapist understand any allergies, medications, or previous surgeries the client may have had, which can influence the massage technique or products used during the session.
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It is a form used to gather information about a client's health history and preferences for massage therapy.
Clients who are seeking massage therapy services are required to fill out the form.
Clients must provide accurate and detailed information about their health history and preferences for massage therapy.
The purpose is to ensure that the massage therapist has a better understanding of the client's needs and can provide safe and effective treatment.
Information such as medical conditions, allergies, injuries, medications, and preferred massage techniques must be reported.
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