Massage Intake Form Template

Use the massage intake form to collect client information before attending their massage session. The idea of this form is to document personal and medical information and for the client to sign consent.

Check out the massage intake form below:

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CLIENT DETAILS

Please tick all that apply

EMERGENCY CONTACT INFORMATION

Please add a contact phone number and email address

MEDICAL DETAILS

Please detail your current exercise schedule
Arm, leg, neck, etc.

FINAL STEPS

Welcome to _________. Because the Terms and Conditions contain legal obligations, please read them carefully.

1. YOUR MASSAGE AGREEMENT

By agreeing to this, you agree to be bound by, and to comply with, these Terms and Conditions. If you do not agree to these Terms and Conditions, please do not use click agree.

PLEASE NOTE: We reserve the right, at our sole discretion, to change, modify or otherwise alter these Terms and Conditions at any time. Unless otherwise indicated, amendments will become effective immediately. Please review these Terms and Conditions periodically.

2. PRIVACY

Your information will be logged in our system and will not be shared with 3rd parties.

What’s in Our Template?

In our massage intake form, we’ve included the following fields:

  • Extensive personal client details
  • Emergency contact information
  • A medical history overview section
  • A question highlighting any current aches/pains
  • Terms and conditions (waiver/consent)
  • A signature field

The terms and conditions and signature field are essential to receive the written client consent before their massage. This means you have their agreement of any present risks to cover you legally if anything were to happen during the treatment. 

Remember, this massage intake form is 100% customizable, so feel free to add or remove fields and update the terms and conditions section to suit your requirements.

Use This Template