Massage By Don
Certified Massage Practitioner, CMP #29311

Client Forms

These are the forms I use to customize your sessions, as well as track progress. Unless otherwise indicated, the client forms are required to be on record prior to or at the time of your first visit. You can complete the forms onlne or fill them out by hand. Please print them out and bring them with you. If you are unable to complete the forms and bring them beforehand, please arrive an extra half hour before your appointment for completion and review. 

The practitioner forms are for my use.


Client Forms - Pre-session --> First Visit
**Please complete these forms prior to arriving for your initial appointment.**

Informed Consent 
Health Information 
Health History 
Intake Form 

Client Forms - Pre-session --> To be completed when applicable

Informed Consent for a Minor
Physician's Permission form
 
Physician's Referral form  

Client Forms - Post session and as necessary

Client Feedback form 

Practitioner Forms

Screening Questionnaire Form 
Body Map for Clients
Care Chart
Session Notes 
Client Status
Client Treatment Plan
Withdrawl From Case 

Forms courtesy of ABMP and 

Sohnen-Moe.com

Associated Bodywork & Massage Professionals
© Copyright 2017  Massage By Don.  All rights reserved.