Massage Therapy Consent template

1. Nature of Treatment

• Massage therapy involves manual manipulation of soft tissue to relieve tension, improve circulation, and support relaxation. Techniques and pressure will be adjusted to my comfort and preferences, which I may communicate at any time.

2. Draping and Comfort

• I understand that appropriate draping will be used throughout the session and that only the areas being treated will be uncovered, with my consent. Massage is a professional, therapeutic service and any inappropriate conduct will result in the session ending immediately.

3. Risks and Contraindications

• Massage may cause temporary soreness, bruising, or lightheadedness. I confirm I have disclosed all relevant medical conditions, injuries, pregnancy, allergies, and medications that may affect treatment.

4. Confidentiality and Data Protection

• My health information is kept confidential and processed under the UK GDPR and Data Protection Act 2018.

5. Cancellation Policy

• I agree to give at least 24 hours' notice to cancel or reschedule; late cancellations may incur a charge.

Client Information

• Full NameText
• Date of BirthDate
• Relevant Medical ConditionsText
• Phone / EmailText

Therapist Information

• Therapist NameText
• Registration / Insurance No.Text

Emergency Contact

• Contact NameText
• Relationship / PhoneText

Acknowledgment and Signature

• Client SignatureSignature
• Date signed (client)Date
• Therapist SignatureSignature
• Date signed (therapist)Date

• By signing below, I confirm I have disclosed relevant health information and voluntarily consent to massage therapy treatment.