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Massage Client Intake Form Template for Australia

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Key Requirements PROMPT example:

Massage Client Intake Form

"I need a comprehensive Massage Client Intake Form for my new mobile massage therapy business launching in March 2025, with particular emphasis on home-visit safety protocols and client pre-screening requirements."

Document background
The Massage Client Intake Form is a foundational document used across Australian massage therapy practices, wellness centers, and healthcare facilities. It serves as the initial point of contact between the service provider and client, collecting crucial health information, establishing informed consent, and documenting treatment preferences. The form must comply with Australian privacy laws, health records legislation, and professional practice requirements. It typically includes sections for personal information, medical history, consent forms, and liability waivers. This document is essential for risk management, treatment planning, and maintaining professional standards in accordance with Australian healthcare regulations.
Suggested Sections

1. Personal Information: Client's basic details including name, date of birth, address, contact information, emergency contact, and occupation

2. Health History: Current health conditions, medications, surgeries, injuries, and chronic conditions that might affect treatment

3. Current Symptoms: Present complaints, pain areas, and specific concerns the client wants addressed

4. Lifestyle Information: Exercise habits, stress levels, occupation-related physical activities, and daily activities that may impact treatment

5. Treatment Preferences: Pressure preferences, areas to focus on or avoid, and specific massage techniques preferred or contraindicated

6. Medical Clearance Statement: Client's confirmation that they have disclosed all relevant medical conditions and understand the importance of full disclosure

7. Informed Consent: Client's acknowledgment of treatment risks, benefits, and agreement to receive massage therapy

8. Privacy Statement: Information about how personal data will be collected, used, stored, and protected in compliance with Privacy Act 1988

9. Cancellation Policy: Terms regarding appointment cancellations, late arrivals, and associated fees

10. Client Signature: Space for client signature, date, and therapist signature confirming information receipt

Optional Sections

1. Insurance Information: Required when the client is claiming treatment through health insurance or WorkCover

2. Pregnancy Information: Additional section for pregnant clients including due date, trimester, and pregnancy-specific conditions

3. COVID-19 Screening: Temporary section for pandemic-related health screening and protocols

4. Minor Consent: Required when the client is under 18, including parental/guardian consent and signature

5. Physician Contact: Optional authorization to contact client's healthcare providers if needed

6. Photo Consent: Optional permission to take before/after photos or use photos for marketing purposes

7. Email Marketing Consent: Optional consent to receive newsletters, promotions, and appointment reminders

Suggested Schedules

1. Body Chart: Diagram where clients can mark areas of pain, tension, or concern

2. Medical Conditions Checklist: Comprehensive list of common medical conditions for clients to check off

3. Medications List: Detailed list of current medications, supplements, and treatments

4. Treatment Plan Template: Therapist's section for documenting proposed treatment plan and progress notes

Authors

Alex Denne

Head of Growth (Open Source Law) @ ¶¶Òõ¶ÌÊÓÆµ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions

























Clauses




















Relevant Industries

Healthcare

Wellness and Beauty

Sports and Recreation

Alternative Medicine

Medical Tourism

Hospitality

Corporate Wellness

Allied Health Services

Relevant Teams

Legal

Compliance

Clinical Operations

Client Services

Administration

Risk Management

Health Information Management

Quality Assurance

Front Desk Operations

Wellness Services

Relevant Roles

Massage Therapist

Remedial Massage Therapist

Sports Massage Therapist

Spa Manager

Wellness Coordinator

Healthcare Administrator

Clinical Director

Compliance Officer

Risk Management Officer

Practice Manager

Client Services Coordinator

Allied Health Professional

Physiotherapist

Health Records Manager

Industries







Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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