Sample Forms

Massage Client Intake Form

November 3, 2014

A massage client intake form is a document that massage therapists use before beginning a massage session to gather information from their clients. The form includes the client’s personal information, medical history, and any injuries or illnesses that may impact the massage.

Massage therapists must use a thorough intake form to ensure the safety of their clients and to customize the massage based on their requirements to provide a more effective and personalized massage therapy experience for their clients. Aside from documenting massage sessions, the form is also used for medical, consensual, and legal reasons. 

Massage Client Intake Form
Sample
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Contents of the form

A typical massage client intake form will include the following sections:

  • Personal Information – The client’s name, address, phone number, and email. The therapist needs to have this information to contact the client if needed.
  • Medical History – The client’s medical history, including any chronic illnesses, surgeries, allergies, medications, and current health status. The therapist needs to know if the client has any medical conditions that may affect the massage.
  • Massage History – The client’s previous experience with massage therapy, including any previous injuries or problem areas mentioned here. It can help the therapist understand the client’s preferences and tailor the massage accordingly.
  • Injuries and Conditions – This includes any ongoing injuries, illnesses, or conditions that may interfere with the massage. The therapist must be aware of any pain or distress that the client is experiencing.
  • Consent – This section includes a statement indicating that the client has read and understood the information on the intake form and consents to the massage therapy session.

Use Cases

A massage client intake form is essential for ensuring the safety of the client during the massage therapy session. By collecting information about the client’s medical history, the therapist can avoid any potential harm or injury to the client. Similarly, the therapist can provide this information to healthcare providers and help them track the client’s progress.

A massage therapist can also use the information collected in the massage client intake form as feedback and customize the massage according to the client’s preferences and needs. For example, if the client has a history of back pain, the therapist can focus on that area during the massage.

Legal protection is another use case of a massage client intake form, as it can be used by a therapist in case of any adverse reactions or injuries during the massage session. The intake form indicates that the client has provided accurate information about their health status, which can help the therapist avoid liability.

Importance of using the form

A massage client intake form is important for the massage therapist as well as the client. It summarizes essential information about the client’s medical history, preferences, and needs for the therapist, which can help them provide a safe and effective massage. It guarantees that the massage is tailored to the client’s specific needs and that their safety is prioritized. It also serves as a document for consent and legal protection.

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