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Lymphatic Drainage Massage Intake
Name: ___ Date of Birth: ___
Address: ___
___
Home Phone: ___ Cell: ___ circle preferred (H) or ©
Email: ___
Emergency Contact:: ___ Phone: ___
Referred By: ___
Have
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How to fill out lymphatic drainage massage consent
01
Begin by explaining the purpose of the lymphatic drainage massage consent form to the client.
02
Provide a brief overview of the procedure and potential risks or side effects.
03
Have the client read through the form carefully and ask any questions they may have.
04
Have the client sign and date the form to indicate their consent to the massage.
05
Make a copy of the signed form for both the client and your records.
Who needs lymphatic drainage massage consent?
01
Anyone receiving a lymphatic drainage massage treatment should complete a consent form in order to ensure that they are fully informed and agree to the treatment.
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What is lymphatic drainage massage consent?
Lymphatic drainage massage consent is a form that a client signs to give permission to a therapist to perform lymphatic drainage massage, acknowledging understanding of the procedure and its benefits.
Who is required to file lymphatic drainage massage consent?
Practitioners offering lymphatic drainage massage are required to file consent from their clients before initiating the massage.
How to fill out lymphatic drainage massage consent?
To fill out the consent form, clients typically need to provide their personal information, describe their medical history relevant to the massage, and sign indicating their understanding and acceptance of the procedure.
What is the purpose of lymphatic drainage massage consent?
The purpose is to inform the client about the treatment, ensure they understand the risks and benefits, and formally obtain their permission to proceed with the massage.
What information must be reported on lymphatic drainage massage consent?
The consent form must report the client's full name, contact information, medical history, any current health conditions, and the client's signature and date.
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