TemplatesMassage
massage client intake form
A client intake form is a first-visit document, which makes it the one chance to gather history properly before a relationship makes the questions feel intrusive.
- 14-day trial
- No card needed
- Set up in 10 minutes
- Cancel anytime
- screening questions
- 10screening questions
- stop the appointment
- 3stop the appointment
- minutes to set up
- 10minutes to set up
- a month to start
- $8a month to start
Massage intake and consent
Full name
Date of birth
Email
Phone
Have you had surgery or an injury in the last 3 months?
YesNo
Blood clot or DVT
Why this form, specifically
It gets the cancellation policy acknowledged before the first no-show, which is a bigger annual cost for most independent therapists than any clinical risk on the form.
Look before you download
The whole document, before you give us anything
Massage intake and consent
Your details
Full name
Date of birth
This is where your aftercare instructions go.
Phone
Health questions
Have you had surgery or an injury in the last 3 months?
Do you have high or low blood pressure?
Do you take blood thinners, or aspirin daily?
This is the form you get
Not a sample, not a preview of a preview. Every question below is in your account ten minutes after you sign up, with the flags already set and the aftercare email already written.
- 14-day trial
- No card needed
- Set up in 10 minutes
- Cancel anytime
The 10 answers that should stop you
A client intake form is a first-visit document, which makes it the one chance to gather history properly before a relationship makes the questions feel intrusive. The health screening is identical to every other massage form; what changes is the depth on preferences and history.
Do not treat
3WhyPressure over a deep vein thrombosis can dislodge the clot. This is the one absolute contraindication every massage curriculum leads with.
What goes wrong if you treat anywayPulmonary embolism. This is the reason the question is on the form.
What to doDo not treat until their doctor confirms it is resolved and clears them in writing.
The question that catches itDo you have, or have you had, a blood clot or DVT?
WhyMassage increases circulation, which can spread a systemic infection and worsen how the client feels.
What goes wrong if you treat anywayA sicker client, and an infection risk to you and the next person in the room.
What to doRebook. Have a clear no-charge sick policy so people are not financially motivated to come in ill.
The question that catches itAre you unwell, or do you have a fever today?
WhyDirect contact spreads impetigo, fungal infections and scabies efficiently.
What goes wrong if you treat anywayTransmission to you, to your linens and to the next client.
What to doAvoid the area, or postpone if it is widespread. Change and hot-wash all linens either way.
The question that catches itDo you have any skin infection, rash or open wounds?
Proceed with caution
7WhyDeep pressure causes micro-bleeding into tissue that anticoagulated blood does not stop quickly.
What goes wrong if you treat anywayExtensive bruising from pressure that would be unremarkable on anyone else.
What to doLight to medium pressure only, and check in during the session rather than after.
The question that catches itDo you take blood thinners, or aspirin daily?
WhyFirst-trimester caution is convention rather than strong evidence, but positioning matters throughout and supine work is inadvisable later on.
What goes wrong if you treat anywayDiscomfort, dizziness from vena cava compression, and an insurer who expects a pregnancy qualification.
What to doSide-lying with support from the second trimester. Check your insurance covers pregnancy massage before you offer it - many base policies do not.
The question that catches itAre you pregnant or breastfeeding?
WhyHealing tissue and scar formation are disrupted by direct pressure, and post-surgical clot risk is elevated.
What goes wrong if you treat anywayDisrupted healing, pain, and in the early window a clot risk.
What to doAvoid the site entirely. For major surgery, ask for surgical clearance before any work at all.
The question that catches itHave you had surgery or an injury in the last 3 months?
WhyMassage lowers blood pressure. On someone already low, standing up afterwards is the risk.
What goes wrong if you treat anywayDizziness or fainting at the end of the session.
What to doSit them up slowly, offer water, and do not leave the room while they get off the table.
The question that catches itDo you have high or low blood pressure?
WhyThe old blanket contraindication has been retired, but lymphoedema risk, bone metastases and port sites all need specific accommodation.
What goes wrong if you treat anywayHarm at a fragile site, or a lymphoedema flare, from a technique chosen without knowing.
What to doOncology massage training or a doctor's clearance. Avoid radiotherapy fields, ports and any limb at lymphoedema risk.
The question that catches itDo you have a condition, or take medication, that affects healing or immunity?
WhyReduced bone density makes ribs and vertebrae vulnerable to firm pressure.
What goes wrong if you treat anywayA rib fracture from pressure the client asked for.
What to doLight pressure, avoid direct spinal and rib work, and do not increase pressure on request.
The question that catches itDo you have osteoporosis or any bone condition?
WhyNeuropathy means reduced sensation, so the client cannot reliably tell you the pressure is too much.
What goes wrong if you treat anywayTissue damage the client does not feel happening.
What to doModerate pressure, inspect feet and lower legs before working on them, and check in verbally more often.
The question that catches itDo you have diabetes?
What you actually get
Nobody buys a consent form
They buy the fifteen minutes back at the start of an appointment. They buy the phone call they did not have to make, because the contraindication turned up two days early instead of two minutes late. They buy an insurer who pays out, because the patch test has a timestamp rather than a memory attached to it.
The form is the mechanism. What you are actually buying is the record it leaves behind.
That is the whole argument, and it is why the questions matter more than the software. A blank form builder hands you a canvas and calls it flexibility. This hands you the nine questions that a waxing client should be asked, in the wording that gets an honest answer, with the risky one already flagged in red.
What this saves you
Not what the form contains - what it gives you back. Every number below is arithmetic you can check on the calculator further down the page.
12 hours
a year, back in your chair
A new client filling in a paper form in your treatment room costs ten to fifteen minutes of an appointment they already paid for. Send it with the booking confirmation and that time goes back into treating, at roughly twelve hours a year on twenty clients a week.
Before they sit down
not halfway through
A form that collects answers and does nothing with them has solved the wrong problem. A risky answer turns the submission red and names the reason at the top, at the only moment the information is worth anything.
Seconds
to find any client's form
The reason to leave paper is not the signing, it is the finding. When a health inspector or a solicitor asks for one specific record from eighteen months ago, you search a name instead of an afternoon.
A defensible claim
instead of a disputed memory
Most professional policies in these trades condition cover on documented screening, and a patch test you can describe is not a patch test you can produce. A timestamped record is the difference between a claim your insurer defends and one they decline.
Same week. One thing changed.
The left-hand column is most studios today. The right-hand one is the same week with the form sent at booking instead of handed over on arrival.
- Your regular mentions her calf has ached since a flight
- The intake update became a two-sentence chat months ago
- You work the area, because that is what she asked for
- Nothing on paper says you asked about clots since her first visit
Nothing here is negligent. It is just undocumented.
- A fifteen-second health re-check goes out before every session
- The flight and the calf pain are answered before she arrives
- The clot question is flagged, and you refer instead of treating
- Every session's consent, including draping, is on the record
Same treatments, same clients, same you. Different record.
Try the flag
Answer these as if you were the client
Answer honestly and nothing happens. Answer yes to the one that matters and watch what lands on your side.
What the client sees
Do you have, or have you had, a blood clot or DVT?
Are you unwell, or do you have a fever today?
Do you take blood thinners, or aspirin daily?
Are you pregnant or breastfeeding?
What you see
Answer honestly and nothing happens. Answer yes to the one that matters and watch what lands on your side.
In your submissions list
Massage
What goes wrong without it
The most expensive thing on a massage practice's books is not a claim, it is empty slots.
A new client books a ninety-minute appointment, does not arrive, and is surprised to be charged, because the cancellation policy was on the website's footer and mentioned by nobody. She disputes the charge with her card issuer and wins, because the therapist has no record that the policy was ever presented to her. It happens four more times that year. None of it is a clinical failure and all of it is a documentation failure, and the fix is one acknowledged line on the form she filled in before her first visit.
What a massage client intake form has to cover
The actual field list, and why each group is on this particular form.
New client details
- Full name and preferred name
- Date of birth
- Contact details
- Emergency contact
- How did you hear about us
- Occupation
Occupation is the most underrated question on a massage form. A hairdresser, a cyclist and a software developer arrive with three completely predictable and completely different patterns of tension.
Massage history
- Had a professional massage before
- How recently and how often
- Types tried
- Pressure preference
- Anything that has been uncomfortable before
- Anything you dislike
'Anything you dislike' catches the things clients will not raise unprompted - feet, face, scalp, being talked to - and it is the single highest-return question for rebooking rates.
Health screening
- Blood clots or DVT
- Recent surgery or injury
- Blood pressure
- Diabetes
- Osteoporosis
- Cancer history
- Pregnancy
- Medication including blood thinners
- Skin conditions
The same clinical list as any massage form, in the same order, because the priority does not change with the client's experience level.
Session preferences and consent
- Areas to focus on
- Areas to avoid
- Music, conversation and lighting preference
- Draping consent
- Cancellation policy acknowledged
- Signature with timestamp
Preferences belong on the form rather than in the room. A first-time client will not tell you she would rather not chat, and asking on paper lets her say so without the awkwardness.
Is a digital signature legally valid?
Exact time signed
IP address
Device and browser
The exact form they saw
Yes - the US ESIGN Act and the state UETA adoptions give it the same legal effect as ink. What makes it hold up is the evidence stored beside it, and a paper form in a drawer carries none of this.
Sign with your fingerDraw a signature with your mouse or trackpad
Where you stand legally
The obligations are the same as for any massage record: state board retention rules, commonly four to seven years, production on request, and consent that covers draping and sensitive areas explicitly. What is worth separate attention on a new-client form is data minimisation. Massage intake forms have a tendency to expand over time, accumulating fields for insurance details, physician contacts and full medication lists that a wellness practice never uses. Every field you collect is a field you must store, secure and eventually delete, and a practice that does not bill insurance has no reason to hold a client's insurer details. Collect what changes the treatment. Second, the cancellation policy: acknowledging it at intake, in writing, is what makes it enforceable in practice, and no-shows are a larger financial problem for most independent therapists than any clinical risk on the form. Check your board's specific record rules. Not legal advice.
Paper, PDF or digital?
Paper
Fine when you are small
- Signed before they arrive
- Flags contraindications
- Findable by name in seconds
- Proves when it was signed
- Sends aftercare automatically
- Costs nothing
Emailed PDF
Worst of both
- Signed before they arrive
- Flags contraindications
- Findable by name in seconds
- Proves when it was signed
- Sends aftercare automatically
- Costs nothing
Digital
Earns its place at scale
- Signed before they arrive
- Flags contraindications
- Findable by name in seconds
- Proves when it was signed
- Sends aftercare automatically
- Costs nothing
Three clients a week? Print it and staple it in a binder. That is genuinely fine, and software would be an expense with no return. Digital earns its place around ten to fifteen clients a week, when finding one form again matters more than the minutes it took to file it.
Questions people actually ask
Contact and emergency details, massage history and preferences, the full health screening, areas to focus on and avoid, draping consent and an acknowledgement of the cancellation policy. Twenty to twenty-five questions is the practical ceiling.
Your form is written. Come and get it.
Pick your service, and it is in your account before you have finished making a coffee. 14 days free, no card.
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- No card needed
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- Cancel anytime
General guidance for professionals, not legal or medical advice. Check the rules that apply where you work.