INFORMED CONSENT FOR BREAST MASSAGE 2026

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The document is an informed consent form for breast massage, outlining the legal requirements and client rights under NRS 640C.700(4)(c). It emphasizes the importance of understanding the treatment's nature, purpose, benefits, risks, and comfort levels. Clients must voluntarily consent to the procedure, with options for how they wish to receive the massage. The form also allows clients to withdraw consent at any time and includes signatures from both the client and therapist.

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Click ‘Get Form’ to open the INFORMED CONSENT FOR BREAST MASSAGE in the editor.
Begin by entering your name in the designated field at the top of the form, ensuring it reflects your legal name for accurate record-keeping.
In the section discussing treatment purposes, select the appropriate reason for your breast massage, such as recovery from surgery or scar improvement.
Review the treatment plan details provided by your therapist. Ensure you understand all aspects, including benefits and risks, before proceeding.
Indicate your comfort level with various massage techniques by checking the corresponding boxes. This is crucial for establishing a safe and comfortable environment.
Sign and date the form at the bottom to confirm your consent. Your therapist will also sign to acknowledge this agreement.

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What states allow massage?

3 states allow massage with informed consent: NH, NY, NC. 5 states allow massage with written consent: AZ, MI, PA, TX, UT. 1 state allows massage with written consent when client and therapist are the same gender: TN. 4 states allow massage with written consent and education: IN, KY, OR, WA.

What is an example of consent for massage therapy?

I understand that the massage I receive is provided for the basic purpose of relaxation and relief of muscular tension. If I experience any pain or discomfort during the session, I will immediately inform the therapist so that the pressure and/or strokes may be adjusted to my level of comfort.

What 5 parts of the body are not allowed to massage?

These are areas of the body where deep, sustained pressure should be avoided because of the structures that lie beneath. Those areas are the anterior and posterior triangles of the neck, suprasternal notch, sternum, axilla, spinal column, umbilical area, inguinal triangle, popliteal fossa, and the antecubital fossa.

What areas are off limits during a massage?

States Without Regulations Only five statesCalifornia, Kansas, Minnesota, Vermont, and Wyominghave no widespread regulations, though certain cities and counties within those states have their own rules regarding the legal practice of massage.

What is informed consent for massage?

Informed consent is a fundamental ethics and legal component of any health and wellness practice. Massage practitioners should require ALL clients to give informed consent before providing them with massage therapy or bodywork services.

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