Home
Forms Library
Massage health history form

Massage Therapy Medical History Form 2025

massage health history form Preview on Page 1

See details

4.1 out of 5

52 votes

The document is a Massage Therapy Medical History Form that collects personal and medical information from clients seeking massage therapy. It includes sections for contact details, medical history, current medications, past and present health conditions, and consent for communication with primary care providers. The form emphasizes the importance of transparency regarding health status and outlines the practitioner's limitations in diagnosing or treating medical conditions.

Here's how it works

01. Edit your massage health history form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send health history form massage therapy via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out Massage Therapy Medical History Form with DocHub

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the Massage Therapy Medical History Form in our platform.
Begin by entering your name, address, and contact information in the designated fields. This ensures that your therapist can reach you if necessary.
Fill in your birth date and occupation. This information helps the therapist understand your background and any potential health considerations.
Provide details about your family doctor and emergency contact. Initial whether you permit consultation with your primary care provider for a comprehensive approach to your health.
Indicate if you have received professional massage therapy before, along with the date of your last session. This helps gauge your experience level.
List any current medications and past or present health conditions from the provided options. Be thorough to ensure safe treatment.
Answer questions regarding pregnancy and infectious diseases, if applicable, to inform the therapist of any special considerations.
Finally, read the acknowledgment statement carefully, sign, and date the form to confirm that all information is accurate.

Start filling out your Massage Therapy Medical History Form online for free today!

See more Massage Therapy Medical History Form versions

We've got more versions of the Massage Therapy Medical History Form form. Select the right Massage Therapy Medical History Form version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2017	4.1 Satisfied (52 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How to see if massage is covered by insurance?

Verify Coverage with Your Insurance Company When you contact your insurance, ask about codes 97124 (Massage Therapy), 97140 (Manual Therapy), 97112 (Neuromuscular Re-Education), and 97010 (Hot/Cold Pack Therapy). Ask if your policy covers these treatments.

What is the difference between medical massage and massage therapy?

Although medical massage may use some of the same techniques as other types of massage, the main difference between medical massage and other massage types is that medical massage has a focused approach to specifically address a physician-diagnosed issue.

How do you document massage therapy?

SOAP notes are a standard way of documenting massage therapy sessions. They allow you to track the progress of your clients, as well as provide information to insurance companies and other professionals. In this blog post, we will discuss how to write massage therapy SOAP notes, as well as provide some examples.

What should be on a medical history form?

A comprehensive history intake includes the patients medical history, past surgical history, family medical history, social history, allergies, and medications.

How to get medical massage covered by insurance?

One of the most effective ways to secure insurance coverage for massage therapy is to obtain a physician referral. Since massage therapists are not licensed to diagnose medical conditions, a physician referral with an ICD-10 diagnostic code increases the likelihood of insurance reimbursement.

massage therapy health history form

Massage therapy medical history form pdf Massage therapy medical history form pdf free download Massage therapy Intake form PDF free CMTO health history form PDF Massage therapy medical history form 2021 Massage therapy medical history form pdf free Free printable massage intake forms Massage therapy medical history form free

Will insurance pay for medical massage?

Coverage for medical massage therapy depends on how the treatment is classified by the insurance company. If it is deemed medically necessary or falls under habilitative or habilitation treatment, it may be covered as an essential health benefit.

How do I create a massage intake form?

How to Create a Massage Client Intake Form Step 1: Create a new Google Form. Step 2: Include questions for personal information. Step 3: Add a field to describe health history. Step 4: Add a field to mention areas of concern. Step 5: Include necessary consent agreements. Step 6: Create an intake document automatically.

How to get medically necessary massage?

The only way you can get them to pay for a massage is if you get a referral from your primary care doctor to a physical therapist and the physical therapist decides that you need it, AND that physical therapist even offers it.