Massage Therapy Forms




Detailed paperwork and documentation is essential in your massage practice!  There are many forms you must have, and many others that just make life easier! 

Below are some sample, generic forms.  They have been pulled from various sources and unless noted as such, were not created by The Massage Store. 

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From Sohnen-Moe Associates, here are some very useful forms....

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Business Management
Wheel of Life ok ok ok n/a
High Priority Activities ok ok ok ok
Daily Plan ok ok ok ok
Time Tracking Sheet ok ok ok ok
Strategic Planning ok ok ok ok
Contact/Referral Records ok ok ok ok
Business Mileage Sheet ok n/a n/a n/a
Employment Agreement ok ok ok ok
Independent Contractor Agreement ok ok ok ok
Procedure Manual Checklist ok n/a n/a n/a
Business Plan Checklist ok n/a n/a n/a

Client Records
Acupuncture - Informed Consent ok ok ok ok
Acupuncture - Records Checklist ok ok ok ok
Attorney Lien 1 ok ok ok ok
Attorney Lien 2 ok ok ok ok
Chart Form, SOAP ok n/a n/a n/a
Chart Form, CARE ok n/a n/a n/a
Client Discharge Letter ok ok ok ok
Client Health Information Sheet ok ok ok ok
Client, Inactive Survey ok ok ok ok
Client Intake Form ok ok ok ok
Client Intake Form, Estheticians ok ok ok ok
Client Intake Form, Seated Massage ok ok ok ok
Client (New) Checklist ok ok ok ok
Client Interview Checklist ok ok ok ok
Client Health History ok ok ok ok
Client Session Notes ok ok ok ok
Client Session Notes (Estheticians) ok ok ok ok
Client Status Report ok ok n/a n/a
Client Treatment Plan ok ok ok ok
Financial Agreement ok ok ok ok
Informed Consent for a Minor ok ok ok ok
Insurance Pre-Approval Form ok ok ok ok
Massage Therapy Informed Consent ok ok ok ok
Medical Records Release Form ok ok ok ok
Withdrawal from Case ok ok ok ok

Financial Management
Balance Sheet ok n/a n/a n/a
Opening Balance Sheet ok ok ok ok
Bank Reconciliation Form ok ok ok ok
Business Income and Expense Forecast ok ok ok ok
Business Expenses Summary Sheet ok ok ok ok
Cash Flow Forecast ok ok ok ok
Gift Certificate Register ok n/a n/a n/a
Monthly Business Expense Worksheet ok ok ok ok
Monthly Disbursement Ledger Sheet ok ok ok ok
Monthly Personal Budget Worksheet ok ok ok ok
Profit and Loss Statement ok ok ok ok
Start-Up Costs Worksheet ok ok ok ok
Weekly Income Ledger Sheet ok ok ok ok
Marketing
Target Market Analysis ok ok ok ok
Building An Effective Network ok ok ok ok

HIPAA
Client Consent for Treatment, Payment, and Health Care ok ok ok ok
Release of Information Authorization ok ok ok ok
Privacy Policies ok ok ok ok
Facsimile (FAX) with Confidentiality Notice ok ok ok ok
Electronic Messaging (e-mail) Confidentiality Notice ok ok ok ok
hipaa Business Associate Addendum ok ok ok ok

Miscellaneous Forms/Handouts
CMS 1500 (formerly HCFA1500) ok n/a n/a n/a
CMS 1500 Instructions ok n/a n/a n/a
Six Steps To Resolve Ethical Dilemmas ok ok ok ok
   pdf wpd
doc
rtf