Physicians Referral/Prescription Form


Many medical conditions benefit from massage, including: Tendonitis, Bursitis, Frozen Shoulder, Migraines, Carpal Tunnel Syndrome, Scoliosis, Temporomandibular Joint Dysfunction (TMJ), Degenerative Disc Disease, Whiplash, Osteoarthritis, Sciatica, Cervicalgia (neck pain), Gastrointestinal Concerns and other ailments.

A massage prescription provides direct communication from your doctor to your massage therapist about what types of treatment you will benefit from and anything that should not be done. It is the best way to integrate your massage therapist into your healthcare team.

A massage prescription may be needed to receive reimbursement from your insurance company depending on your medical healthcare plan. Ask your doctor to provide you with a massage prescription. As a convenience, you can download the PDF form and take it to your next doctor’s visit.

searchDownload PDF – Physician Referral/Prescription Form
from PalmLeaf Massage Clinic


Related Links:
Can I Use My Health Savings Account (HSA) for Therapeutic Massage?
Can I Use My Flexible Spending Account (FSA) for Therapeutic Massage?
Medical Insurance: The Connection Between Therapeutic Massage and Your Health