Massage Therapy Intake Form

The Massage Therapy Intake Form is designed specifically for massage therapy practices, capturing the health history and treatment preference information that licensed massage therapists need for safe, effective bodywork. This template collects patient demographics alongside a detailed body map of tension and pain areas, pressure preference (light, medium, firm, deep), areas to focus on and areas to avoid, and treatment goals (relaxation, pain relief, injury recovery, flexibility, stress management). The form balances thoroughness with simplicity, recognizing that massage clients expect a streamlined intake process.

Built for therapeutic massage, sports massage, deep tissue, prenatal massage, and relaxation massage practices, this form includes critical contraindication screening covering current injuries, recent surgeries, skin conditions (rashes, wounds, burns, contagious conditions), cardiovascular conditions (blood clots, varicose veins, uncontrolled hypertension), pregnancy status and trimester, cancer or active treatment, osteoporosis, diabetes, and areas of numbness. The medication section focuses on blood thinners, muscle relaxants, pain medications, and topical treatments that may affect the massage session. Health history captures relevant conditions without being overly clinical.

All fields are HIPAA-compliant and structured for the massage therapy intake workflow. The contraindication screening ensures client safety by identifying conditions that require modification of technique, avoidance of certain areas, or physician clearance before treatment. The preference section helps the therapist customize the session to the client's needs from the first appointment, improving client satisfaction and retention.