Image shows a massage therapist wearing gloves while working on a client, to illustrate the concept of COVID-19 precautions in a massage therapy practice.

While most clients cancel if they are feeling at all unwell, some clients do show up to an appointment symptomatic. To protect your health, ask your clients to answer some questions beyond your regular intake—at every session.

The close-contact nature of this profession requires that we create a plan of how to navigate and protect ourselves in a world of where transmissible viruses create alarm and could potentially impact our health or income.

With new COVID-19 variants circulating (and substandard booster rates in the U.S.)—plus a predicted influenza surge this winter on top of the recent monkeypox outbreak, it is clear that massage therapists must use enhanced procedures to maintain the safety of their own and clients’ health.

Processes & Protocols to Navigate the New Normal

The best solutions I can offer are all based on creating better preventive measures such as:

• Practicing higher standards of cleaning and sanitizing

• Consistently ask the right questions more frequently than in past practice

• Having protocols for client illness and cancellation and notify clients of policies

• Being prepared to cancel when appropriate, even if that is when the client arrives.

While the first three solutions are protocols many of you have likely implemented into your businesses, the last solution is what I would like to spend some focused time on in this article.

To create more preventive measures for both client and therapist health, it has become essential to cue our clients to do a safety and health self-check-in per appointment. While most clients cancel if they are feeling unwell at all, some clients do show up to an appointment symptomatic.

Performing a health check-in is easy and should be completed either verbally or written for each client session.  

Outside of these measures, what I have observed is that the difficulty lies not in dealing with the new normal of being required to have a heightened sense of awareness; it is how to follow through with the policies set up for health and safety when a client fails the checkup and they are already in your office.

Ethical Dilemmas of Face-to-Face Cancellations

I recently taught a live ethics class on health and sanitation practices, specific to what we are dealing with here. While the information was straightforward on enhanced cleaning protocols and processes to follow, there was an interesting question that came from a therapist who had been practicing for only a short time.

She asked how to handle cancelling a massage either with information the client presented after arriving or during the session. She had worked on a client, just the week before, who had a rash on their back and did not disclose that prior to the massage. The therapist became aware of the rash after she was already half-way through the massage session.

While she avoided the area, she felt uncomfortable and was unsure of how to stop the massage at the point. To add to this, she was employed and was unsure what her employer would allow her to do in this instance.

She said that she finished the massage because she had felt unsure of what to do in that moment and then wanted to know what to do in the future to avoid this scenario or handle an in-session cancellation.

This question supplied the opportunity for an enlightening discussion, as several of the therapists discussed how they would have, or have, managed this type of issue. I observed that this topic was more of an ethical dilemma because of how therapists were comfortable, or uncomfortable, with different levels and standards of health and well-being.

Some therapists were more concerned about the clients’ expectations of receiving the massage that day and upsetting them over potential or unclear health issues. While others were more cautious for themselves and willing to cancel for any reason, some therapists voiced opinions about following specific outlined health and safety guidelines and making sure those rules were followed above all.

As an educator, what I realized was this discussion wasn’t about safety protocols or correctly determining an illness issue. The real issue was about how to handle the situation it places you in as the therapist when the client is directly in front of you.

Being Prepared for the Cancellation

Here are some questions for you to ask yourself concerning business practices and also how you are going to handle a cancellation inside your office, either when a client arrives or potentially mid-session. I highly recommend writing down how you would answer these questions to best prepare for answering them in the future.

• Do I have updated cancellation policies and processes in place and made all clients aware of these policies?

• Do I currently have health and wellness policies posted in my office?

• Have I prepared myself to cancel an appointment as the client is sitting in my office, waiting for a massage?

• Have I outlined, created, and practiced a verbal answer to aid myself with these types of cancellations?

• Am I prepared to deal with a disappointed and frustrated client at having their appointment cancelled upon arrival?

• Based on the standards of care set forth, am I ready to maintain those boundaries regardless of the cost and to handle this scenario with professionalisms and a positive attitude?

In the face of so many unknows with COVID-19, monkeypox, influenza and whatever else may be around the corner for us next, the best thing we can do is to be prepared and aware. As a rule of thumb, when within reasonable doubt, don’t massage and be prepared to cancel a session if the client arrives and it is not safe for you to touch them that day.

This is a sample massage therapy health and safety checklist you can use with your clients:

Massage Therapy Health and Safety Check-In

To create more preventive measures for both client and therapist health, it has become essential to cue our clients to do a safety and health self-check-in per appointment. To improve the safety of your massage experience, please review the following. Check the box of any that apply to you:

Within the last 48 hours, have you experienced any of the following conditions?



Unusual respiratory issues

Loss of taste and/or smell

Painful joints or muscles that are an unusual experience for you

Exhaustion or extreme fatigue unusual for you

Any skin lesions or new rashes

Any rash that is worsening or has turned into blisters or boils

Swollen lymph nodes; new or recently observed

Have you recovered from COVID-19 within the last six months?

Do you have any residual side effects form COVID-19 that I should be aware of?

Please explain:

Amy Bradley Radford

About the Author

Amy Bradley Radford, LMT, BCTMB, has been a massage therapist and educator for more than 25 years. She is the owner of Massage Business Methods and the developer of PPS (Pain Patterns and Solutions) Seminars CE courses and a National Certification Board for Therapeutic Massage & Bodywork-approved CE provider. Her articles for this publication include “A Massage Approach to Whiplash” and “The Client’s Body Does the Healing (The MT Provides the Opportunity).”