Templates Health & Wellness Massage Therapy Client Intake Form Template

Massage Therapy Client Intake Form Template

Use This Template
Please enable JavaScript in your browser to complete this form.

Client Information


Massage Therapy Details

(medical conditions, injuries, surgeries, allergies, medications, and current symptoms)

Consent and Authorization


Do you want to optimize your massage therapy sessions for maximum benefit and comfort? Look no further than our Massage Therapy Client Intake Form Template.

Using the Massage Therapy Client Intake Form Template

Incorporating our form into your website can streamline your client’s experience and guarantee that you have all the necessary information to tailor the session to their unique needs.

  • Client Information: The form begins by capturing essential details such as the client’s name, contact information, address, date of birth, and gender. This section lays the groundwork for establishing a personal connection and allows therapists to maintain accurate records for future reference.
  • Massage Therapy Details: Going deeper, clients are prompted to articulate their reasons for seeking massage therapy and provide their health history. Additionally, clients can share their previous experiences with massage therapy. Then areas of focus and areas to avoid fields empower clients to communicate their preferences and any areas requiring special attention, further personalizing the treatment experience.
  • Emergency Contact: Prioritizing client safety, the form includes fields for emergency contact information, ensuring that therapists have access to vital resources in case of unforeseen circumstances.
  • Consent and Authorization: The form concludes with a consent and authorization section, where clients affirm their consent to treatment and release the organization from liability, sealing it with their signature. This element underscores the importance of transparency and establishes clear boundaries within your relationship.

By leveraging this invaluable tool, you can cultivate deeper connections, deliver personalized treatments, and ultimately enhance the overall quality of care for your clients.

Ready to build your own intake form? Signing up with WPForms grants you access to the Massage Therapy Client Intake Form Template and thousands of other great templates for your business.