5.3 Consultation Documents, Minors, and Draping

The initial consultation

Before a client's first massage-therapy session, section 117.91 requires the licensee to provide an initial consultation and obtain the client's signature on the consultation document. The rule specifies what must appear. A general medical intake can be useful, but it does not replace the eight legal elements.

The document includes:

1. the massage services or techniques the licensee anticipates using;
2. the body parts to be massaged or avoided, including indications and contraindications;
3. a statement that female clients' breasts will be draped and that female breast massage requires written consent before each session;
4. a statement that the genital area and gluteal cleavage of every client will be draped at all times;
5. a statement that the client may ask the licensee to stop for any reason and the licensee will end the session;
6. a statement that the licensee may end the session if the licensee is uncomfortable for any reason;
7. a statement that the licensee must immediately end the session if the client initiates verbal or physical contact that is sexual in nature; and
8. the signatures of both the client and licensee.

The rule does not require an emergency contact, full systems review, annual rewrite, or SOAP format as an element of the statutory consultation. A prudent practice may gather more information, but a jurisprudence answer should not convert optional risk-management choices into Chapter 117 mandates.

When to update

If the client's reason for seeking massage changes, or if the anticipated techniques, treated or avoided areas, or breast-massage information is modified, the licensee provides an updated consultation reflecting the changes. Section 117.91 does not say the entire written consultation must be re-signed before every unchanged routine visit. It targets the initial session and material changes described by the rule.

A brief pre-session safety check may be good practice, and an updated condition can affect indications or contraindications. For the examination, distinguish sensible practice from the specific trigger for an updated consultation.

Minors

Section 117.90(g) requires written consent from a parent or guardian before providing massage to a person under 17. Under 17 means age 16 or younger. A 17-year-old is not within that specific subsection's parental-consent requirement.

The rule does not require the parent to remain in the treatment room or elsewhere on the premises. It also does not create a blanket prohibition on every abdominal or breast-related service for a minor. Other draping, consultation, scope, consent, safety, and sexual-misconduct rules continue to apply. Never invent extra conditions and attribute them to section 117.82, which governs establishments rather than client consultation.

Mandatory draping

Section 117.90(u) requires draping and treatment sufficient to protect client safety, comfort, and privacy. At minimum, the licensee must drape:

• the genital area and gluteal cleavage of all clients at all times; and
• the breasts of female clients at all times unless performing breast massage specifically authorized as section 117.91 requires.

Client preference does not waive the genital and gluteal-cleavage rule. Draping can expose only the area necessary for lawful treatment while preserving these required zones. The rule does not prescribe a particular sheet-tucking technique, mandate that every treatment-room door remain unlocked, or say a therapist must use a specific number of linens.

The client controls the decision to stop. The consultation expressly communicates that the client may request cessation for any reason. The licensee also may stop when uncomfortable and must immediately stop for client-initiated sexual conduct under section 117.92.

Records

Section 117.90 requires accurate records of service dates, massage types, and billing and keeps those records for at least two years. Section 117.82 requires an establishment to maintain and secure initial consultations, session notes, written consents, and related billing records. These rules support proof that the consultation and draping plan were established. They do not require diagnosis or medical-style charting outside the massage scope.

Scenarios

New adult client: complete and sign the eight-element consultation with the licensee before massage.

Existing client changes the requested area: update the consultation to reflect the new treated or avoided area.

Sixteen-year-old: obtain written parent or guardian consent in addition to the consultation and other requirements.

Seventeen-year-old: the specific under-17 parent-consent subsection does not apply; normal consultation and draping rules do.

Client requests exposed gluteal cleavage: decline that request and maintain the required drape.

Female client requests breast massage: drape by default and follow the new signed-and-dated written-consent rule before each session in which it will occur.

Question-reading method

Look for first session, changed plan, age, anatomical area, and whether the behavior is sexual. Those five facts point to the consultation, update, minor-consent, draping, and termination rules without adding assumptions.