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Massage Intake Form Template
A client intake form for massage therapists: contact details, health history checklist, focus areas, consent, signature. Print it blank or headed; nothing is uploaded.
Private by construction. The document is assembled by this page's JavaScript as you type. Names, prices, and photos never leave your machine, and the page keeps working with the network unplugged. Printing uses your browser's own print dialog — choose "Save as PDF" there to get a file.
Type your practice name and this page turns into your intake form: letterhead on top, a nine-line health-history checklist covering the conditions that actually change how a therapist works — injuries, blood pressure, clots, skin, allergies, pregnancy, medications — then focus and avoid areas, a pressure preference row, and a consent paragraph a client can read in thirty seconds. It is designed to be printed blank and filled by hand at the front desk, which is exactly how health information should travel: on paper, into your filing cabinet, never through a template site's server. Even the practice name you type here stays in your browser.
Questions this template gets asked
What should a massage intake form ask?
Contact and emergency details, a health history focused on conditions that change technique or are contraindications - recent injuries, cardiovascular issues, clots, skin conditions, allergies, pregnancy, relevant medications - plus the client's preferences and a consent statement. This form covers that set on one page.
Why print it blank instead of typing the client's answers?
Because a health history belongs on paper in your records, not in a web form. Clients fill it by hand in the waiting area, which is faster at the desk and keeps their health information entirely offline. The name and date fields exist for practices that pre-fill scheduled appointments.
How should completed forms be stored?
Securely and privately: a locked cabinet or an encrypted system, access limited to the treating therapist. If you practice in a jurisdiction where massage records are health records, retention and privacy rules apply - check your licensing board's requirements.
How often should clients update their intake form?
Have every new client complete one, and ask returning clients to review it yearly or after any significant health change - surgery, pregnancy, new medication. A quick verbal check-in each session catches the rest.
Is this intake form free, without a sign-up?
Yes - no account, no watermark, no per-form fee. Type your letterhead, print a stack, done. Nothing typed on this page is transmitted anywhere.
