A massage intake form is a questionnaire given to new massage clients to understand their needs before treatment. The form asks for crucial information about the client’s health, current concerns, and any specific goals they have for their massage treatment or bodywork. Depending on the client’s needs and the therapist’s specialization, massage services may be for relaxation, detoxification, or to treat an injury or condition.

Key Components
First Appointment
Related Forms (4)

Key Components

The massage intake form should ask for the client to provide the following:

1. Client Information

This section will request the client’s basic information, such as their name, address, phone number, email address, and emergency contact.

2. Health Information

The client will need to disclose any past and present health issues. These could include surgeries, injuries, chronic conditions, allergies, medications, or any other condition that may put them at risk. Based on the health information provided by the client, the therapist will adapt their treatment to ensure the safety and well-being of the client.

3. Massage Information

The therapist will also need to know the reason for the client’s visit, whether it’s for relaxation or to address a particular concern. If it’s the client’s first professional treatment, the therapist will often walk them through the process to ensure a smooth experience.

4. Informed Consent

A massage intake form will commonly include a section in which the client acknowledges they have provided accurate health information and understand the possible risks of massage therapy. By including this acknowledgment, the therapist can protect themselves from most liabilities that may arise if the client has an undesirable outcome.

5. Client’s Signature

The client will need to sign the form to affirm that they consent to the treatment and that the information provided is complete and accurate.

First Appointment

At the client’s first massage appointment, the therapist will often review the intake form and ask some clarifying questions before proposing a course of treatment for that session. During the massage, the therapist will be able to determine the most effective approach to address the client’s needs. If the session goes well, the therapist may propose a treatment plan or simply ask the client if they’d like to book a second appointment.

Related Forms (4)

Esthetician (Facial) Client Intake Form – Used by estheticians to collect client information before treatment.

Download: PDF, Word (.docx), OpenDocument

Massage Therapist Service Contract – A contract that massage therapists can use to relay the terms by which they agree to provide services to a client.