The Massage Client Intake Form is a crucial document required for all massage therapy services provided in Qatar. This form serves multiple purposes: it collects essential client health information, documents informed consent, and ensures compliance with Qatar's healthcare regulations and privacy laws. The document must be completed before any massage therapy service can be provided, helping practitioners identify contraindications, understand client needs, and maintain proper medical records as required by the Ministry of Public Health. The form is designed to address Qatar's specific cultural considerations and legal requirements while protecting both the service provider and client. It includes sections for personal information, medical history, consent forms, and cultural preferences, making it suitable for use in various settings from luxury spas to medical facilities.
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1. Personal Information: Client's basic details including full name (as per Qatar ID), date of birth, Qatar ID/passport number, contact information, and preferred language
2. Emergency Contact Information: Details of person to contact in case of emergency, including relationship to client and contact numbers
3. Medical History: Comprehensive health background including current medications, chronic conditions, surgeries, and specific contraindications for massage
4. Current Health Status: Present health conditions, areas of pain/concern, stress levels, and immediate health concerns
5. Service Preferences: Preferred massage type, pressure level, areas to focus on or avoid, and gender preference for therapist (important in Qatar's cultural context)
6. Consent and Liability: Client's acknowledgment of risks, consent for treatment, and liability waiver in accordance with Qatar law
7. Privacy Policy Agreement: Statement on data collection and usage in compliance with Qatar's Personal Data Privacy Protection Law
8. Payment Information: Preferred payment method and billing details in accordance with Qatar's financial regulations
1. Pregnancy Information: Additional section for pregnant clients, including trimester, medical clearance, and specific pregnancy-related concerns
2. Sports/Activity Information: For clients seeking sports massage or treatment for activity-related issues
3. Previous Massage Experience: Client's history with massage therapy and any previous treatments
4. Cultural/Religious Preferences: Specific requirements regarding modesty, gender interaction, or religious observations
5. Insurance Information: For clients seeking insurance coverage or reimbursement for medical massage
6. Corporate Client Details: Additional information for clients under corporate wellness programs
1. Medical Conditions Checklist: Detailed checklist of common medical conditions and contraindications
2. Body Map: Diagram for clients to mark areas of concern or pain
3. Service Menu and Pricing: List of available massage services and current pricing in Qatar Riyal
4. Clinic Policies: Detailed policies including cancellation, late arrival, and hygiene requirements
5. COVID-19 Screening Form: Additional health screening questions as per Qatar Ministry of Public Health guidelines
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