Sample Digital Forms

Simplify the creation of Sensitive Area forms by using the content from our Assessment and Treatment forms.  Your patient digitally signs the forms, it is associated to a SOAP Note and it is stored in the profile.  It is that easy.

Gluteal Treatment Consent

Following a discussion and review of assessment findings, I have requested treatment by the Massage Therapist for treatment of the Gluteal Area.

As part of my therapeutic treatment, I am aware that my Massage Therapist will treat the Gluteal Area.

The Massage Therapist has explained the:

• The nature of the assessment, including the clinical reason(s) for treatment of the above
  area(s) and the draping methods to be used
• The expected benefits of the treatment
• The potential risks of the treatment 
• The potential side effects of the treatment
• Alternative courses of action
• Likely consequence of not having the treatment
• That consent is voluntary
• That I can withdraw or alter my consent at any time. 

Gluteal Assessment Consent

I  have requested a Gluteal assessment by the Massage Therapist

As part of my therapeutic assessment, I am aware that my Massage Therapist will Assess the Gluteal Area.

The Massage Therapist has explained the following to me and I fully understand the proposed Gluteal assessment including:

• The nature of the assessment, including the clinical reason(s) for assessment of the above area(s) and the draping methods to be used
• The expected benefits of the assessment
• The potential risks of the assessment
• The potential side effects of the assessment
• That consent is voluntary
• That I can withdraw or alter my consent at any time. I voluntarily give my informed consent for the assessment as discussed and outlined above.