Get the free Massage Referral Form

This form is used to refer patients for massage therapy, capturing essential patient information, referral reasons, and necessary insurance details, particularly for auto accidents or workers\' compensation claims. It also addresses tax exemption requirements in Minnesota.

How to fill out massage referral form

How to fill out massage referral form

1. Start with the patient's personal information: name, date of birth, and contact details.
2. Provide the referring physician's information: name, clinic, and contact number.
3. Indicate the reason for the referral: specify the patient's condition or symptoms that require massage therapy.
4. List any specific treatments or techniques that the therapist should focus on.
5. Include any relevant medical history or medications that may affect treatment.
6. Sign and date the form to validate the referral.

Who needs massage referral form?

1. Individuals who are experiencing chronic pain or muscle tension.
2. Patients recovering from surgery or injury.
3. Those with conditions like fibromyalgia, arthritis, or stress-related issues.
4. People referred by a doctor or healthcare provider seeking complementary therapies.

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What is massage referral form?

A massage referral form is a document used to provide a professional referral for massage therapy services, outlining the client's needs and medical history.

Who is required to file massage referral form?

Medical professionals or practitioners who are referring a patient for massage therapy typically need to file a massage referral form.

How to fill out massage referral form?

To fill out a massage referral form, include the patient's name, contact information, medical history, specific areas of concern, and the referring practitioner's details.

What is the purpose of massage referral form?

The purpose of the massage referral form is to ensure that the massage therapist has all pertinent information regarding the patient's health and condition, enabling them to provide safe and effective treatment.

What information must be reported on massage referral form?

The massage referral form must report the patient's name, contact information, medical history, relevant conditions, treatment goals, and details of the referring provider.