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Massage Consent Form for Indonesia

Massage Consent Form Template for Indonesia

A comprehensive legal document designed for use in Indonesia that facilitates informed consent between massage service providers and their clients. The form complies with Indonesian Health Law No. 36 of 2009 and Personal Data Protection Law No. 27 of 2022, ensuring proper documentation of client health information, service acknowledgment, and data privacy considerations. It includes essential sections covering medical history, treatment consent, risk acknowledgment, and personal data handling, while incorporating specific requirements for both modern and traditional Indonesian massage practices.

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What is a Massage Consent Form?

Massage Consent Forms are essential legal documents required in Indonesia for professional massage therapy services, whether provided in healthcare facilities, spas, or wellness centers. These forms serve multiple purposes: documenting informed consent, collecting relevant health information, and ensuring compliance with Indonesian healthcare and data protection regulations. The document becomes particularly important in the context of Indonesia's dual system of modern and traditional medicine practices, where different types of massage therapies may be offered. The form helps protect both service providers and clients by clearly outlining service parameters, potential risks, and data handling practices, while meeting requirements under Health Law No. 36 of 2009 and Personal Data Protection Law No. 27 of 2022.

What sections should be included in a Massage Consent Form?

1. Client Information: Basic personal details including name, date of birth, contact information, and emergency contact details

2. Health History: Medical conditions, medications, injuries, surgeries, and other health-related information relevant to massage therapy

3. Service Information: Description of massage service, duration, and general procedures to be performed

4. Risks and Benefits: Statement of potential benefits and risks associated with massage therapy

5. Client Acknowledgment: Client's confirmation of accurate information provision and understanding of the service

6. Consent Declaration: Explicit consent for treatment and acknowledgment of risks

7. Data Privacy Statement: Information about how personal data will be collected, stored, and used in compliance with Indonesian data protection laws

8. Therapist Declaration: Professional commitment statement and signature section for the massage therapist

9. Signatures: Dedicated space for client and therapist signatures, date, and witness if required

What sections are optional to include in a Massage Consent Form?

1. Pregnancy Declaration: Additional section for pregnant clients including specific trimester-related considerations and risks

2. Photo Consent: Optional authorization for taking before/after photographs for treatment documentation

3. Insurance Information: Section for insurance details if the service is covered by health insurance

4. COVID-19 Screening: Temporary section for pandemic-related health screening and protocols

5. Traditional Medicine Acknowledgment: Additional section when traditional Indonesian massage techniques are used

What schedules should be included in a Massage Consent Form?

1. Medical Conditions List: Detailed checklist of medical conditions that may affect massage therapy

2. Service Price List: Schedule of available massage services and their corresponding prices

3. Anatomical Diagram: Body diagram for marking areas of concern or areas to avoid

4. Treatment Record: Form for documenting each massage session, techniques used, and client feedback

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

Indonesia

Publisher

Genie AI

Document Type

Consent Form

Cost

Free to use
Relevant legal definitions

























Clauses




















Relevant Industries

Healthcare

Wellness and Spa

Beauty and Personal Care

Alternative Medicine

Sports and Recreation

Medical Tourism

Hospitality

Traditional Medicine

Relevant Teams

Legal

Compliance

Operations

Customer Service

Risk Management

Quality Assurance

Medical Services

Wellness Services

Data Protection

Administrative Services

Relevant Roles

Massage Therapist

Spa Manager

Wellness Director

Compliance Officer

Healthcare Administrator

Legal Counsel

Risk Management Officer

Customer Service Manager

Traditional Medicine Practitioner

Medical Director

Quality Assurance Manager

Operations Manager

Data Protection Officer

Industries






Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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