Using a Sensitive Areas Consent Form

Obtaining consent for treating sensitive areas is simple.  Just watch the video below and/or follow the steps listed.


  1. Create a general Sensitive Consent Form Template.
  2. Create a Form for a patient and select Sensitive Consent.
  3. Remove the sensitive areas not being treated.
  4. Press Save.


The sample content used in the video can be found here:


Consent for Assessment and Treatment of Sensitive Areas I, First Name Last Name, have requested assessment and/or treatment by this Registered Massage Therapist
(RMT)  Bob Smith for treatment of the clinically relevant area(s):

  • Buttocks (gluteal muscles)
  • Chest Wall Muscles
  • Upper Inner Thigh(s)
  • Breast (s) (RMT has discussed if areola will be included and why)

The RMT has explained the following to me and I fully understand the proposed assessment and/or treatment:

  • 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 and/or treatment as discussed and outlined above.
Have more questions? Submit a request


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