Massage Therapy Information And Consent
According to New York State, who are massage therapists and what techniques can they use?
Massage therapists are licensed health professionals who apply a variety of scientifically developed massage techniques to the soft tissue of the body to improve muscle tone and circulation. They work to enhance well-being, reduce the physical and mental effects of stress and tension, prevent disease, and restore health.
Different massage techniques include Swedish medical massage, Connective Tissue Massage, Neuromuscular Massage Shiatsu, Tuina, Amma, Reflexology, Acupressure, Polarity Therapy and more.
Consent
● It is my choice to receive massage therapy and I understand that there is no implied or stated guarantee of success or effectiveness of individual techniques or series of appointments.
● I acknowledge that massage therapy is not a substitute for medical care, medical examination or diagnosis. I have stated all medical conditions that I am aware of and will inform my practitioner of any changes in my health status.
● I understand that I have the right to refuse, modify or terminate treatment, regardless of prior consent for such treatment.
● I acknowledge and understand that Massage therapists will not cause more pain than I am willing to accept, nor will they exert any psychological pressure to induce me to accept a level of pain higher than I have expressly agreed to experience.
● I understand that when massage of breast tissue is therapeutically indicated, the female patient/client must be fully informed and give consent before the therapist undrapes the breast for treatment.
● I understand that my personal health information will be collected, I understand that all information that I provide will be kept confidential unless required by law I understand and consent that my medical information may be shared by the various care providers involved in my care and treatment. I understand that I have the right to refuse, modify, or terminate treatment, regardless of prior consent for such treatments.
Minor's Information And Consent
TextBy signing below, you agree that you are the parent or legal guardian of the minor receiving treatment. You understand that if the minor is 16 to 18 years of age, you are required to stay within the facility for the entire duration of the first appointment. For subsequent appointments, you understand that you may choose to leave the facility during the session if you remain reachable by telephone or text. You understand that if the minor is under the age of 16, you must remain in the facility for the entire duration of the massage for each and every session up until the minor is 16 years of age.
You will also be required, if needed; to assist the minor in preparing for his/her treatment(s). We may also request that you remain in the treatment room to supervise all interactions between the therapist and the minor.
You also agree that you have completed the intake form and have informed the therapist of all medical diagnoses, symptoms, medications, and complaints associated with the minor receiving treatment(s).
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