Cupping therapy consent form: the marks, blood thinners and what to say before the cups go on
Cupping has one side effect every client will see: round marks that last for days. A client who expected them shrugs; one who did not, the week of a wedding, is upset. A cupping consent form makes sure nobody is surprised, and asks about blood thinners up front.
This exact form is built into SlickChart: send it to your client's phone to sign before their session, and the cupping aftercare goes home with them.
Say what cupping is, and what it is not
My "about this service" box describes gentle suction from silicone, plastic or glass cups that lifts skin and muscle. Cups stay still or glide. A session runs about 30 to 60 minutes, alone or as part of a massage, and your client should feel a pulling sensation, never sharp pain. It also says plainly that no fire is used.
The same box covers the marks: round marks are common, usually fade in about 3 to 10 days, and usually are not painful. Your client then checks today's session (static cups, gliding cups, or cupping with massage) and writes in the areas.
The possible effects and risks
Eight items:
- Round marks or discoloration for 3 to 10 days
- Temporary redness, itching or skin sensitivity
- Bruising, more likely with blood thinners
- Irritation from an oil or the cup material
- Tenderness or mild soreness in cupped areas
- Lightheadedness, more likely on an empty stomach
- Rarely, blisters or broken skin from strong suction
- Marks that may show in photos or sleeveless clothes
Ask about blood thinners on their own line
Before the general checklist, my form asks one direct question:
Blood thinners or a bleeding disorder? Cupping is usually skipped. We'll choose a different treatment unless your physician has given a written OK.
Your client answers "Doesn't apply to me" or "Physician OK on file." Spelling out the alternative means nobody feels turned away.
The health check
Fifteen items: a bleeding disorder, active cancer or treatment, very thin or fragile skin, sunburn or rash, diabetes or neuropathy, blood thinners or daily aspirin, a pacemaker or implanted device, steroid medication, open wounds or skin lesions, recent surgery or injury, pregnancy, varicose veins, bruising easily or anemia, a tattoo under 2 to 4 weeks old, and fever or feeling unwell.
A box asks for more about anything checked. A check starts a conversation, never a diagnosis. What a condition means is for their doctor to say. For heat-based work, see my hot stone massage consent form post.
The acknowledgements
- Your client has shared their full health history, including all medications and blood thinners.
- They understand cupping usually leaves round marks that fade in about 3 to 10 days.
- They will speak up right away if suction feels too strong, sharp, hot or numb.
- Cups avoid the front of the neck, large blood vessels, bony areas, moles and broken skin.
- Only dry cupping is offered. No fire is used and skin is never cut.
- Cupping does not diagnose or treat medical conditions and does not replace care from their doctor.
Before and after photos for their private record are OK, with social media use only with their separate OK. The dry cupping line tells your client exactly what is on your menu.
Aftercare that tracks the marks
My cupping guide follows the marks as they fade:
- Today: round pink, red or purple marks, and areas may feel warm, tight or a little tender. Keep marked areas warm and covered and rest. No hot tubs, saunas, cold plunges or intense exercise for 24 hours.
- Days 1 to 3: marks may darken slightly before they fade, and mild itching or stiffness is common. Warm showers, gentle stretching and soft clothing over marks. No sun on marked skin, and no scrubbing, exfoliating or scratching.
- Days 3 to 10: marks lighten to yellow or brown, then fade, and darker marks take longer. Cover them or use sunscreen outdoors. No cupping, scrubs or strong pressure on the same area until they fade.
- 2 to 4 weeks: book the next session and tell you about health or medication changes, including before starting blood thinners.
The good-to-know list says mark color varies from person to person, and makes a point I like: dark marks are not a sign of "toxins" leaving. Cupping supports comfort; it does not cure conditions.
The call-me list covers blisters or broken skin, warmth, swelling or pus around a mark, pain that gets worse instead of better, and marks still dark after 2 weeks. Spreading redness, pus or fever means seeing a doctor. Chest pain, trouble breathing or fainting means calling 911.
Questions to decide for your own practice
- Will you photograph the marks at the end of each session, so you can compare next time?
- What will you offer a client on blood thinners who has no written OK?
- What does your state board require? Whether cupping is within your scope, and the consent rules for it, vary by state, so check with yours. This post is not legal or medical advice.
New clients fill in an intake first; see my massage intake form post, or browse the full massage therapist forms collection.
Use this form with your clients
SlickChart has this exact cupping consent and aftercare built in for subscribers. The form goes to the client's phone to sign before the visit, or they sign on your device at the table, and any contraindication they check is flagged for you. The aftercare lands in the client's own app, styled with your logo, and it all works alongside the Square account you already have. If that would save you paperwork, try SlickChart.
Prefer paper? The printable massage therapist set, with this cupping consent, the protocol and the aftercare, is in my Etsy shop, ready to print or edit in free Canva.