Sports Massage Consent form

THIS FORM MUST BE COMPLETED & SIGNED BEFORE RECEIVING A MASSAGE

Massage Consent form

Please fill out the following form
before receiving your massage.

First name

Last name

Date of Birth

Have you ever experinced a professional massage?

Yes

Which Areas would you like to focus on during this massage?

Would you prefer to have silence or are you happy to listen to relaxing music?

Is there anything you think I should be aware of or have any areas you'd like me to avoid?

Are you taking any medications? If yes please list

Please state below any health conditions we need to be aware of

Is there any reason why your doctor may advise against a massage?

Yes

If yes, ellaborate. If no leave blank.

Recent injuries or medical procedures in the last 2 years?

Emrgency contact name and number:

Please arrive 5 minutes before your scheduled appointment time to allow time to undress and get on the table to enjoy a relaxed and unhurried experience.

All scheduled appointments will end at the scheduled ending time in order for us to stay on schedule. Clients who arrive late to their scheduled appointment will be charged for the full session and will not receive a time extension.

By signing below, I acknowledge that I am aware of the benefits and risks of massage therapy and that I have completed this form to the best of my knowledge. I also agree to inform my massage therapist of any health or medical changes.

I declare that the info I’ve provided is accurate & complete

I accept terms & conditions

Initials

Thanks for submitting!