Contract Basics for Registered Massage Therapists

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massage therapy contract

Contracts. Whether you’re an independent (or sub-) contractor, a clinic owner yourself, or an employee, every massage therapist inevitably has to deal with a contract at some point in their career. Contract terms are a hot topic for many therapists, with most questions about how to handle different work-related situations often boiling down to “what does your contract say?”

Contracts exist to help establish clear expectations of both parties in an professional relationship. A good contract is detailed enough to cover most scenarios, while allowing some  reasonable flexibility for extenuating circumstances. The terms in a contract should be mutually agreed upon, and both parties should take the time to fully understand every clause in the contract. A contract is a binding agreement, but it’s not one you have to accept outright… you can always negotiate with a business owner (or new contractor) to have one, or several, of the clauses removed or adjusted in a way that leaves you both satisfied.

Unfortunately, many massage therapists aren’t familiar enough with employment contracts to know what to look for when deciding if a contract meets their needs, which leads to very uncomfortable situations when they expect one thing and the other party expects another. This short guide should help you decide if your contract touches on all the important stuff.

Treatment Equipment and Space Issues

Room sharing

You’re about to negotiate the use of a space, so you’ll need to know if the space is going to be shared with other people. If so, how many? Is it a set schedule, or a first-come-first-served arrangement, and how are conflicts handled? Who is responsible for cleaning the room?

Equipment  / supplies sharing

In many clinics, massage therapists may share equipment or supplies. These items may be supplied by the clinic owner, or one of the other contractors working out of the location. Who is responsible for providing the treatment supplies and equipment? If you’re sharing the space, can you leave equipment (like your table) inside the space? Who is responsible for maintenance of the equipment in the room, or replacing it if it breaks / is used up? If there is a flood, fire, or other damages caused to the therapist’s equipment while in the clinic, who is responsible for any costs to repair / replace the equipment?

Common space sharing

Nearly every clinic has a shared common area where clients may wait when they arrive early, make payments for their treatments, etc., as well as a washroom for staff / public use, and possibly other areas shared by multiple staff and contractors. Your contract should discuss who is responsible for maintaining those areas. If you are expected to do light office work like answer phones and business emails at the office, book appointments for other massage therapists as needed, and similar tasks,  the contract should outline what those expectations are, and if / how you are paid for those tasks.

Clinical Documentation Issues

Where / how are files stored

The contract should detail how the client’s treatment records are stored, and how long they are kept. The CMTO requires that records are kept for at least 10 years following the date of the client’s last appointment (or the date they turn 18, whichever is later) , but the clinic may keep the files longer if they wish. You’ll want to make sure that the process the clinic uses to store files doesn’t conflict with CMTO, PHIPA, and RHPA  requirements. If they are storing files using a clinic management system, make sure it’s compliant with our privacy requirements.

Who has access to files

In many multi-practitioner clinics, client files are shared between therapists, and other people working at the clinic (like a receptionist or accountant) may have access to some or all of your clients’ records. The contract should detail who has access to those records, and in what context if necessary. It should also detail who the privacy officer at the clinic is, in case you have any concerns regarding file access. If you are expected to be the privacy officer for your records, when / how you can access your records should be detailed… do you have a key to the area where the files are stored? Can you access the clinic after hours?

Scheduling Issues

Who sets work hours

One common reason for tension between contractor and business owner is a contract that doesn’t clearly define who has ultimate control over the therapist’s work schedule, and what the expectations are for availability. Make sure your contract very clearly outlines who determines when the therapist works, as well as what’s expected during “down time” when there isn’t a client scheduled. Is the therapist only expected to come in when they have someone booked? If a client cancels, can they leave? If they are expected to stick around during these hours, are there specific tasks they are supposed to do? Keep in mind that a lot of these questions will impact how the therapist should be classified – if they have minimal control over their hours, have to do office work or clean during down time periods, etc., they are likely to be considered employees by the CRA. Misclassifying staff can have serious consequences, so make sure you consult with the CRA first if you think you might be walking the line.

How often are hours subject to change

Work schedules change for a large number of reasons – seasonal hours, other employment positions, business growth, etc. The contract should discuss the process for changing the massage therapist’s regular hours. Who makes the final call? How much notice needs to be given? Is there is a minimum or maximum number of hours that need to be adhered to? How often can the regular hours be updated?

Holidays, sick days, and prolonged absence expectations 

Independent contractors are not “employees” when it comes to labour laws. There are no clear requirements in place for handling holidays, sick days, and prolonged absence periods (like maternity leave). This lack of clear guidelines makes it especially important that your contract explicitly discusses these items so that both parties know what to expect if the therapist wants or needs time away from the clinic.  How much time does the therapist want for holidays during the year? How are sick days handled – is there a limit on their number? What happens if appointments have to be rescheduled due to therapist illness? How is prolonged absence handled? A clinic hiring an independent contractor doesn’t have any obligations if the therapist goes on maternity / paternity leave (no maternity / paternity pay or job security), so outlining the expectations for these scenarios will help prevent any issues if they occur.

Locum (subletting) options and expectations

In the event of prolonged absence, many therapists consider using a locum – another therapist who will occupy their space and treat their clients during their absence. Your contract should discuss the expectations in this area. Can the therapist use a locum, or does the clinic want to reserve the right to rent the space to someone else themselves? If a locum is hired, how are the finances handled… does the locum pay the therapist or the clinic? What happens if the prolonged leave needs to be shortened or extended? Will the locum be using their own equipment, or sharing the therapist’s or clinic’s equipment? Do they have to adhere to the same schedule the regular therapist had in place?

Keep in mind that a separate contract will need to be created between the locum either the therapist or the clinic (or maybe both) as well.

Cancellation Policies

Good contracts will outline how client cancellations are handled by the clinic. If a client doesn’t show up for an appointment, are they billed anyway? Are they billed a partial amount? Are they given a freebie? If the clinic is paid a partial or complete fee for the service, is the therapist paid as per normal? Is the policy enforced?

Financial Issues

Who sets the fee schedule

This is another area of contention for a lot of therapists without explicitly detailed contracts. Which party has control over the fees being charged? How often can the fees be changed? Are discounting or sliding-scale fee structures allowed? If so, which party absorbs the loss in income? Can each therapist offer different prices? There are a lot of potential areas for confusion (and eventual disagreement) if the expectations and responsibilities of each party are not spelled out in detail in this area.

The same issues of employee classification we discussed in the scheduling section apply here. The more control the clinic has over the fee structure of the therapist, the more likely they should actually be classified as employees and not independent contractors. Make sure to contact the CRA if you’re not sure how your staff should be classified.

How often is payment made

This is a point missing in many contracts. If the therapist is paying monthly rent, exactly when is the payment due? What is the process if they pay late? If the clinic is paying the therapist’s invoice for their cut, how often is this done? What is the interest rate if they pay late? What happens if the client doesn’t pay the clinic / therapist on time? What about insurance or MVA claims, in which payment might come in several days or weeks after the service is provided?

Who does the client pay for services

Who the client is actually paying for the service will determine a number of things: how each party will handle their taxes, who should invoice whom at the end of the month (or other payment period), whose information should appear on receipts, and others. For example, does the therapist collect all the money and pay the clinic their rent and administrative fees every month? Does the clinic collect all the money for services rendered and pay the therapist their “cut” every few weeks? Your contract should be very clear on who is collecting the money from the client, and which party is paying the other at the end of each payment period. Who the client is paying for the service also has a huge impact on HST requirements.

How is HST handled

Which party the client is paying for the service, and whether or not that party is registered (either voluntarily or by requirement) to collect HST, will determine whether or not HST should be applied to the service. If you’re not sure whether or not you are currently required to register for HST collection, you can check out my article on HST basics to read up on the requirements and figure it out. Even if the therapist isn’t registered to collect HST, it’s possible the clinic will have to charge HST on the service if the clients pay the clinic for the service.

In some scenarios, the clinic will collect and remit 100% of the HST collected, in other scenarios, it might be more appropriate for the therapist to collect and remit it all, or the collection / remission may be split up between the two parties. There are a number of acceptable ways of doing it, but your contract should outline what process you plan to use.

Also, the contract should be clear about what happens if / when the therapist is eventually required to collect and remit HST (once they hit the required limit) if they aren’t registered already. Will the fees go up? Will the therapist (or clinic) absorb a portion of the increase, and if so, by what amounts?

Who is responsible for payment processing fees

If your clinic has a payment processing machine (credit / debit card machine), your contract should outline who is responsible for paying the fees for each transaction. Will the clinic absorb the cost? Will the therapist be expected to pay a fee to the clinic each time they use the machine? Is the therapist permitted to use the machine at all, or should they use their own?

Who is responsible for all relevant business and operational expenses

The contract should explain who is responsible for payment for any operational costs. If the therapist has to purchase their own supplies, which supplies they are expected to provide should be clearly outlined, and which (if any) supplies and equipment the clinic will provide should be listed as well. The expectations for use of resources like computer equipment, fax machine, support staff, software (like clinic management programs or online schedulers), and other similar things should be made clear in the contract. If maintenance, repairs, replacement, or labour costs increase, it should be clear who is responsible for those costs.

Marketing expectations

Marketing expectations can be a lot more complicated than it might seem at first. There are some obvious items, like who is responsible for paying for items like newspaper, radio, tv or online advertising, but there are many other things to consider. Are therapists expected to market themselves, or will the clinic handle all of the marketing? Is the therapist expected to attend any particular marketing events like marathons, fundraisers, home / trade shows, or other events on behalf of the clinic? Is all of the marketing to be done under the name of the clinic, or can the therapist market their own brand? Who has the final say in what content appears on the clinic’s website, print ads, or other materials? Who is responsible for designing / printing business cards, brochures, and other internal materials? Is the expectation that the client will always contact the clinic, or can the marketing materials include the therapist’s cell phone number or other contact information?

Time frame for renegotiation

You should include a time frame for renegotiating the terms in the contract. A therapist who has built a following of clients, and who requires very little oversight or marketing support will represent a much different investment than a new therapist without any existing client base. You’ll periodically want to go over your contract and amend the terms so that both parties feel they are still benefiting from the arrangement. Things like fee schedule changes, work schedule adjustments, percentage splits, may need occasional adjustments, so setting up a time frame to go over the contract again periodically helps facilitate the process.

Leaving the Practice

Non-competition / Non-solicitation clauses

If your contract includes a non-competition or non-solicitation clause, it should be reasonable and mutually agreed upon. What is reasonable will depend on many factors, like how big your town is, if you have access to a vehicle, where you intend on working once you leave, and what limitations are being imposed on you. The purpose of a non-competition / solicitation clause isn’t to limit your ability to find gainful employment (which wouldn’t be legal), or to prevent clients from seeking care from a therapist they choose (which would also be illegal). These clauses are meant to help minimize any significant loss of business assets (clients) when a therapist moves on. I’ve already written a lot more about this topic in a previous article, so check it out for more information on this subject.

Notice required before leaving

Any notice expectations for leaving the practice should be outlined in the contract. How much notice does the therapist have to give the client owner? If the clinic owner wants to discontinue the business relationship with the therapist, how much notice do they need to provide?

Expectations for notifying clients

The CMTO requires three things happen with clients when a therapist is leaving a practice.

  1. The client is notified that the massage therapist is leaving / has left.
  2. The client is made aware of where they can access their health record as needed.
  3. The client is referred to another health care provided for continuation of care (if necessary). This can be another therapist in the same clinic, but it doesn’t have to be.

There is no requirement on the part of the therapist to tell the client where they are going, which is a common misunderstanding of the regulation. The regulations also say that the therapist can make arrangements for someone else to notify the clients; they don’t have to do it personally. However, the therapist (not the clinic) is ultimately responsible for ensuring the clients are notified. Your contract should describe who will notify the clients of the therapist’s departure. It is also a good idea to mutually draft the “departure notice” that will go to clients as soon as you start at the clinic, and write it into the contract. That way, when the massage therapist is ready to move on, you’ve both already agreed on the wording that will be used with clients. It’s always best to figure that out in advance, in case the terms of your departure aren’t amicable.

Escape (exit) clauses

Escape clauses describe what happens if either party wants to sever the agreement. Although this can be caused by one party not living up to their end of the arrangement (ex: a clinic owner who wants the therapist to do office work despite it not being a part of their arrangement, or a therapist who abuses their sick days and cancels appointments on a regular basis), it could also be for unforeseen circumstances like a car accident preventing the therapist from treating their clients. Regardless of the reason, there should be a clear process in the contract describing how either party can terminate the contract at any time. How much notice is required? Will the massage therapist have continued access to the building for a certain time after they leave? What will clients be told if they ask where the therapist has gone? What happens to the client files – are they staying at the clinic, or going with the therapist? What is the process if the therapist requires access to any notes left at the clinic after they’ve departed?

Solid, detailed contracts make for much smoother business arrangements. Not having a detailed contract might seem more “friendly” or “easy-going” at first, but it is one of the biggest reasons for conflict in a business relationship. It’s better to settle all the details right from the get-go than assuming you’ll always agree on business decisions and never “need” a contract. This article has detailed some of the most common clauses and terms found in massage therapy contracts, and should be enough to get you started. Make sure you understand every part of every clause in the contract before you sign it, and don’t ever sign a contract that has terms you don’t agree with or intend to honour. A contract is a legally binding document, so not living up to your end can have serious consequences. Only sign a contract if both parties feel they are being treated fairly.

Bryan Quesnelle
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About Bryan Quesnelle

I lead a double life as a registered massage therapist and a web developer in Kitchener, Ontario. When I'm not treating patients or developing products for ClinicWise, I'm usually building websites for other businesses and organizations.