R156-47b-306. Client Intake Form Requirements

(1)(a) Under Subsection 58-47b-306(1)(b), a licensee shall require that each client complete a client intake form before the first session; and (b) before each new session, a licensee shall review the most recently completed intake form with the client and confirm all information is current. (2) Under Subsection 58-47b-306(1)(b), a licensee's intake form shall include at least the following: (a) the name of the massage establishment or the sole practitioner; (b) the date of the session; (c) the client's: (i) first and last names; (ii) birth year; (iii) contact information; and (iv) emergency contact; (d) if the client is seeking a massage for a specific health issue; (e) the client's health history including: (i) each major medical issue; (ii) each allergy; (iii) a current acute injury as defined in Subsection R156-47b-102(2); (iv) a current subacute injury as defined in Subsection R156-47b-102(21); and (v) if the client is currently under the treatment of a physician; (f) the client's right to: (i) disrobe in privacy and to the client's comfort level; (ii) ask questions; (iii) identify areas of the body the client would like the licensee to avoid; (iv) modify the treatment; (v) stop treatment; and (vi) be properly draped; (g) policies regarding: (i) cancellation; and (ii) no show; and (h) signed consent to treatment.