You asked, we answered

Frequently asked questions and CMTBC’s responses follow.

Do existing patients from prior to January 15, 2019 need to sign a consent form? 

No. Until the introduction of the Consent Standard of Practice which came into effect on January 15, 2019, verbal or written consent to delivery of massage therapy was acceptable.

Under the Consent Standard of Practice, written consent — obtained through a signature on a consent form — is only required at a new patient’s initial treatment.

Any subsequent consent may be obtained verbally and must be documented by the RMT in the patient’s record.

If an RMT has treated a patient prior to January 15, 2019, that patient is not a new patient and the RMT does not have to request that the patient sign a consent form. However, if the treatment approach changes or if the patient’s clinical presentation changes and requires a change in direction of treatment, verbal consent must be sought and recorded by the RMT in the patient’s health record. Patients must be advised that consent can be withdrawn at any time, and a new treatment approach can be negotiated as needed.

Do RMTs need to create a new template consent form?

Not necessarily. The Consent Standard of Practice states that a consent form describes the treatment to be provided by the RMT, and should be signed by the patient either with a physical signature or an electronic indication of consent. It does not necessarily require RMTs to create a new template consent form. In most cases, the consent form that an RMT was using prior to the introduction of the Consent Standard of Practice in January 2019 will continue to be acceptable.

CMTBC advises registrants that a consent form should include a description of the general framework of a massage therapy treatment (intake, treatment plan, assessment, treatment involving manual, hands-on manipulation and mobilization, and home care). RMTs can consider referring to the scope of practice statement for massage therapy, contained in the Massage Therapists Regulation.

Does CMTBC have a sample consent form available?

No, CMTBC does not make sample consent forms available. This is because there are many variations of forms that may be acceptable, and as a regulatory body CMTBC does not want to be prescriptive and suggest that there is only one type of form that is acceptable, particularly because RMTs have varied practices with different areas of focus or different preferred population groups.

Can a new patient sign the consent form before arriving at the initial appointment?

No. A signature by the patient on a consent form does not meet CMTBC’s requirements unless the RMT has discussed the form with the patient and provided the patient with an opportunity to ask questions. 

If an RMT sees the same patient at two clinics, is a consent form required in each clinic?

No. One signed consent form is adequate. It confirms consent between the patient and the RMT and can be accessed when needed.

Does an RMT need to renew consent from a patient at each subsequent treatment?

No. A patient’s written consent must be obtained at the patient’s initial appointment, in accordance with the standard of practice on consent.

The standard requires that an RMT renews consent at a subsequent treatment if necessary. An RMT must renew consent when the treatment approach changes for any reason, and the RMT revises the treatment plan or creates a new one.

Does it matter where the consent agreement is stored, for an RMT who provides mobile service as well as clinic-based practice?

No. A signed consent form can be stored where the RMT can access it when needed. Remember, the RMT must offer to provide a copy of the signed form to the patient.

How should a patient’s verbal consent be documented in the patient record?

As set out in the application to practice section of the Consent Standard of Practice, documentation of verbal consent should include:

• confirmation that criteria for valid consent were met;
• when and how consent was obtained;
• concerns raised during the consent process, and actions taken to address concerns;
• reason for refusal or withdrawal from massage therapy services; and
• reasons for determining that a patient was not capable of making an informed decision, and action taken to identify a parent/guardian or substitute decision-maker.

When documenting verbal consent in the patient record, the entry should also outline that an RMT has provided sufficient information to enable the patient to make an informed decision about treatment, as required by the consent standard and by provincial legislation.

A clinic has a signed consent form for a patient who will receive treatment from other RMTs during her regular therapist’s maternity leave. Are new consent forms required?

If the RMT has effectively transferred care to a new RMT (or several), and the new RMT has a different clinical framework from the patient’s previous RMT, it is appropriate to get a new signed consent form and provide an opportunity for the patient to ask questions about the new RMT’s practice model.

If the clinical framework of the new RMT is essentially the same as the patient’s previous RMT, it is acceptable to obtain appropriate verbal consent as necessary.