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Click ‘Get Form’ to open the massage prescription template in the editor.
In Section A, enter the Patient Information. Fill in the Member/Patient name, date of birth (mm/dd/yyyy), and Premera member identification number accurately.
Proceed to Section B for Referring Provider Information. Input the Referring Provider's name and phone number, ensuring all details are correct.
In Section C, attach your written prescription. Make sure it is legible and includes a diagnosis (ICD-9 code), number of visits, and a start date to avoid any issues.
Review all sections for completeness before submitting. Ensure that you have included a copy of the prescription as required.

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Versions	Form popularity	Fillable & printable
2012	4.8 Satisfied (110 Votes)
2009	4.9 Satisfied (55 Votes)

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How do you document massage therapy?

A massage therapist SOAP note template includes the following information: Clients name and contact information. Date and time of visit. Description of what type of massage was performed. The clients reaction to the massage. Any areas that were sore or felt abnormal before or after treatment.

Can a doctor write a prescription for a massage?

Depending on your situation, your doctor likely will be open to prescribing massage. Licensed therapeutic massage is safe and non-addictive, and medical research consistently supports its effectiveness as a pain-management treatment.

How to get a doctors note for massage therapy?

Ask your doctor for a referral. You must have a referral in order to have your therapy covered by your insurance. Your referral is your only way of proving that medical massage therapy sessions are a medical necessity. For each session of massage therapy you receive will require a valid and current Rx or referral.

How to create a prescription template?

Creating Prescription (Rx) Templates Click on the Rx button in the gray navigation bar at the top of a patients chart. Select Prescription Form (Rx/OTC/CS) Fill in the following fields. Medication name strength. Sig. Qty. Unit. Refills. Days Supply. Packing (NDC) Click Save as Rx template Click Save