massage intake form

Heavy workloads, busy streets, hectic schedules, and piled up bills are some of the common contributors to an individual’s stress. This is the reason why massage centers and sessions are available in order for people to have a quiet and stress-free time for themselves. Massage therapists are professional individuals who conduct their clients’ massage sessions with the aid of a massage intake form and other essential documents. You may also see intake assessment forms

Massage Intake Form Sample

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What Is a Massage Intake Form?

A massage intake form allows a therapist to acquire the information of his client and acknowledge the client’s medical condition. With the form, the therapist can determine the type of massage applicable for the client’s well-being as well as the materials to be used such as massage oils and the specific scents of the candles. The form must be provided to the client before his appointment begins, which can either be sent through an email or will be handed personally as the client arrives at the massage center. You may also like massage consent forms

Massage Client Intake Form

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Significant Sections in a Massage Intake Form

Although there are varieties of massage intake forms that highly depend on the expertise and specializations of the massage therapy center, there are certain contents of a massage intake form that should be kept and be included regardless of its variety. Below are five significant sections found in any massage intake form:

1. General information

This is the client’s name, email address, residential address, and contact information. Additionally, an emergency contact information area is also included in order to secure that the therapist will be able to contact the client’s relative in events of emergencies and accidents during the massage session. The information stated in this section must not be disclosed to any third party and must be used limitedly for the purpose of designing an effective or suitable program for the client.

2. Medical history

This is the section where the current and previous illnesses of the client are indicated. The client must state his medical condition which includes allergies, seizures, and infectious diseases. These details will assure the therapist that the condition of the client will not worsen in the duration and after the session. Other inclusions in this section are the indication of the client of whether she is trying to conceive or be pregnant, and the list of medications that the client is taking prescribed by a licensed physician. You may also check out career counseling forms

3. Health information

The reasons why the client wants to obtain the massage services are stated in this section. Details about the exercise programs that the client has, his injuries, and his sought-after therapies must also be included to guide the therapist. In addition, how the client heard about the massage center will be indicated along with this section to determine what activities lead to the massage center’s promotion and advertising toward their clients. You may also see therapy consent forms

4. Acknowledgment statement

The purpose of an acknowledgment statement is to obtain an understanding between the massage center and the client. The acknowledgment focuses on the guarantee of the center, the general schedules, and the discussions that the parties have disclosed for the success of the treatment.

5. The liability waiver and release statement

This last section is essential to inform the client about his responsibilities regarding his health and medical conditions which should be disclosed properly to the massage therapist. The client must then affix his signature at the bottom of the release agreement along with a date to completely fill out the intake form.

Massage Therapy Intake Form

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Examples of Massage Intake Forms

1. Massage and Bodywork Intake Form

This is the common type of massage intake form that can be provided to all massage clients. The form has four sections namely the client information section, session information section, previous history section, and an acknowledgment section. With the form, the massage therapy center can collect the basic data and the medical details of the client. Additionally, the form will also indicate the general agreement of the client to willingly complete the entry fields of the document, understand the capabilities of the therapist, and the obligations of the client to attend his scheduled session as well as pay the fees accompanying the massage services.

Massage and Bodywork Intake Form

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2. Oncology Massage Intake Form

Clients who are diagnosed with cancers and tumors are the target users of this type of massage intake form. The form will determine whether there are swelling, inflammation, and pain in the client’s body. This allows the oncologist to focus on the areas of the client that needed treatment to aid in addressing a cure of the client’s condition. Contents of the form include the contact details of the client, a medical questionnaire, general signs and symptoms of an illness. A formal letter intended to be signed by the client’s physician is also enclosed with the form to obtain further information about the client’s cancer condition.

Oncology Massage Intake Form

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3. Pregnancy Massage Client Intake Form

Pregnancy is a crucial stage in a woman’s life since this can contribute to a medical complication as well as the death of either the mother or the child. With this, a pregnant client must complete a pregnancy massage intake form. The form contains the basic details of the client, her prenatal information, medical problems, and a section that is intended to be used by the massage practitioner only that contains a diagram of the client’s body where the client complained about pain during the massage session. The diagram is significant to be completed by the practitioner with full details to inform the client and her prenatal care provider about the issues that were observed by the practitioner. You may also check out project intake forms

Pregnancy Massage Client Intake Form

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The Importance of Massage Intake Forms

Massage intake forms are not only documents that gather the diagnostics and the medical details of a client but also aid the massage center to document an agreement signed by the client regarding the services that he is requesting. The form must then be kept for documentation purposes by the massage center to acquire a statistical evaluation of the number of clients they are able to handle within a period as well as acknowledge the common illnesses or conditions that their general clients had.

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