Simple forms

[Kerozene]

My job is sending me to a bridal expo to do chair massage, the sessions will only be a few minutes long and free of charge to attract people over to their booth. I feel like my typical intake forms for chair massage aren't necessary since they will be quick sessions, I wouldn't want them to spend as much time on the form as they are in the chair :roll: I was thinking of something along the lines of a sign in sheet with a disclaimer at the top, but I'm not sure how that will go over or if it is looked down upon. Any suggestions? Thanks!

 

[Drunken monkey 17]

When pressed for time in these situations, I find it is appropriate to do a verbal intake.

Ask each person:

Are you being treated for any medical conditions?

What medication have you taken today?

What time was your last meal?

The answers to these questions will give you a basis for further follow-up questions.

You could also have your basic disclaimer wherever you collect their signature, if you wanted.

 

[Rodina]

Thanks! That's pretty much what I had in mind. Is it a bad idea to just have them sign a list? Or should I have separate slips per person?

 

[spotlite28]

For these types of events, I have a the informed consent (disclaimer) information in large font on a "cover sheet" that is laminated. Few people read it even at that, even though they actually have to lift the cover sheet to sign on the list. The cover sheet protects the list from both nosey people and the odd spill. People who are signing in do not really pay attention to the names on the list.

The sign in sheet has name, address, phone or email address, and a ok? with a check mark beside it, which I verbally explain is to verify that they read the disclaimer. BTW, when creating the list, print it out in "landscape" ~ it provides more space for the information.

Definitely have a sign in sheet, as it is the start to a mailing list for potential clients.

HTH

 

[Vengeance of God]

Great idea Denise, I really like that. *files idea away for future use*

 

[7-4-09 baby lills here]

I agree, I love your idea Denise!

How do you word your disclaimer?

 

[Smart]

How do you word your disclaimer?

Kneaded Breaks Consent Form

Please carefully read the following:

Today's treatment is a fully-clothed, seated massage that may include the scalp, neck, shoulders, hands, back and hips -- unless I request that one or more of these areas not be touched. I have the right to stop the treatment at anytime, and/or request different pressure or technique.

It is my responsibility to inform the therapist of my known medical conditions and medications. Side effects of therapeutic massage may include drowsiness, some mild discomfort and (rarely) headaches or bruising. These can usually be relieved with rest and proper hydration. If I have any unusual reactions, I should consult my primary care physician. Massage therapy is not intended to replace necessary medical treatment and my therapist cannot diagnose any symptoms or ailments.

By completing the sign-in (followin page), I affirm that I have read and understand this statement. I am in general good health and of legal age to consent to therapeutic massage treatment at this time.

/end consent form.

I later realized that I should put the same information as "small print" on the sign-in form itself, just in case anyone has issues and says, "That is not what I agreed to; I never read that." If it is on the sign-in itself, it will be on the same page as the signature. O! I forgot to say, I have a space for signature, printed name, address, etc.

DISCLAIMER:
I wrote this, and give permission for it to be used, in whole or in part, in proper context. The user takes sole responsibility for checking its legality in any given jurisdiction.

HTH