Using a Sensitive Areas Consent Form

Practitioners may use a Sensitive Area Area Consent form as it ensures that patients understand and explicitly consent to procedures or treatment involving the sensitive areas of their body and assures ethical and respectful care of delivery. Obtaining consent for treating sensitive areas is simple. Just watch the video below and/or follow the steps listed.

1. Click on Templates.
2. Under Agreements click Add New.
3. Click Start with Blank Agreement.
4. Name the agreement i.e., Sensitive Area for Assessment and Treatment.
5. Click Add.

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.