Prenatal Massage Consent Form for Massage Therapy

Streamline your prenatal massage practice with this professional, ready-to-use consent form. Designed specifically for massage therapists and wellness practitioners working with pregnant clients, this static PDF form helps you:

✓ Document pregnancy-specific health information systematically

✓ Ensure proper informed consent for prenatal treatments

✓ Screen for pregnancy contraindications and complications

✓ Maintain professional practice standards

✓ Create organized maternity client files

✓ Protect your practice

What's Included:

This is a STATIC PDF form that clients can fill out by hand or type directly into the PDF before printing. The form is NOT editable—this ensures document integrity and professional consistency.

Key Sections:

• Client Information (name, contact, date of birth, emergency contact)

• Comprehensive Pregnancy Information (due date, trimester, healthcare provider)

• Prenatal Health Screening (pregnancy-related symptoms and discomforts)

• Contraindications and Safety Considerations (high-risk factors, complications)

• Healthcare Provider Approval documentation

• Prenatal Massage Understanding and education

• Treatment Areas and Pressure Preferences

• Client Acknowledgment & Consent

• Signature Section with therapist notes area

Perfect For:

• Licensed Massage Therapists (LMT) offering prenatal services

• Massage Therapy Clinics specializing in maternal wellness

• Spa and Wellness Centers with maternity massage programs

• Prenatal Massage Specialists

• Mobile Massage Services serving pregnant clients

• Doulas and birth workers offering massage

• New practices setting up prenatal documentation systems

• Established practices updating their pregnancy client forms

Why Choose This Form?

✓ Professional Design: Clean, organized layout that reflects well on your practice and puts expectant mothers at ease

✓ Comprehensive: Covers all essential prenatal health considerations, trimester-specific factors, and pregnancy contraindications

✓ Safety-Focused: Includes thorough screening for high-risk pregnancy conditions and medical clearance documentation

✓ Time-Saving: Ready to use immediately—no design work needed

✓ Practical: Standard 8.5" x 11" size, easy to print and file

✓ Client-Friendly: Clear, supportive language that's easy for pregnant clients to understand and complete

✓ Static PDF Format: Fillable by hand or digitally, maintains document integrity

How It Works:

1. Purchase and download the PDF file

2. Print copies for your practice OR have clients fill digitally

3. Clients can type directly into the PDF before printing

4. Have pregnant clients complete before their first prenatal massage session

5. Review for any contraindications or concerns

6. File in your client records

Note: This is a STATIC PDF. While clients can type into fields before printing, the document cannot be edited or customized. This ensures consistency and professionalism.

File Details:

• Format: PDF (Static, fillable)

• Size: Standard US Letter (8.5" x 11")

• Pages: 5 pages

• Orientation: Portrait

• Print-Ready: Yes

• Digital Use: Yes (clients can type-on before printing)

What Makes This Prenatal-Specific:

This form goes beyond standard massage intake to address pregnancy-specific needs:

• Trimester identification and week of pregnancy

• Due date and healthcare provider information

• Pregnancy-specific symptoms (morning sickness, swelling, back pain, round ligament pain)

• High-risk pregnancy screening

• Prenatal contraindications (preeclampsia, placenta previa, premature labor, etc.)

• Medical clearance documentation

• Positioning preferences and modifications

• Safety considerations unique to pregnant clients

Customer Support:

Have questions? Need customization for your practice?

Contact us—we're here to help wellness professionals succeed!

📧 support@formsolutionspro.com

Important Disclaimer:

This form template is provided for informational and organizational purposes only. It is not a substitute for professional legal, medical, or compliance advice. 

• This template is designed for general wellness massage practices

• Not intended to replace consultation with legal or healthcare professionals

• FormSolutionsPro is not responsible for how this form is used in your practice

• Users are responsible for ensuring compliance with local, state, and federal regulations

• Consult with appropriate licensed professionals regarding your specific practice requirements

• By purchasing, you agree that this is a template tool and not professional advice

Each massage therapy practice operates under different regulations depending on location, scope of practice, and licensing requirements. Please review this template with qualified legal and healthcare advisors to ensure it meets your specific needs.