Myofascial Decompression Cupping

8.2 INTAKE HEALTH HISTORY, CONSENTS & WAIVERS & INFORMATION SHEET

You must first complete 8.1 HOW TO INCORPORATE MDC INTO YOUR PRACTICE before viewing this Lesson

  SAMPLE FORMS 

We have added a few sample forms in which you can modify and use or feel free to make improvements as needed for your practice.  We have a 2 page (Front and Back) Health History Form with a sample Consent Form on the back which contains 2 different consents.  We discovered that cupping can come up at anytime and you don’t want to have to stop a massage session to have them sign a consent for cupping, so at our clinic we had all clients sign both consents.  We explained that it did not give us permission to automatically add cupping without their prior approval, but gave consent should they decide to have cupping added to a treatment or to try a stand alone cupping treatment in the future. 

 

CUPPING INFORMATION SHEET

Education is the key with cupping.  You will find that many want to try it and are either really excited or really nervous.  The more education you can provide the more comforting it is to the client. At our clinic, we gave people the Health History Form and the Cupping Information Sheet and asked them to complete the Health History and then read over the Cupping Information Sheet and then tell us which treatment they feel would be best for them.

This worked great for us as the client was educated and participating in the choice of which treatment they feel is best for them based on their own symptomatic issues.

This is a sample.  Feel free to use it or modify it to improve it for your needs.

 

 

Back to: HOME STUDY: 12 CE INTRODUCTION TO MYOFASCIAL DECOMPRESSION CUPPING > MODULE 8