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Massage Health Intake Form

A massage health intake template — screen clients before a first massage, capturing conditions, medications, tension areas and allergies.

Description

A massage is relaxing, but some conditions change what’s safe, so a quick health check protects the client. This massage health intake form captures a client’s health picture before their first treatment, so the therapist can work safely and effectively.

It takes the client’s name and asks whether any listed conditions apply, with space for details, and any medications they take. It captures where they carry tension or pain, their preferred pressure, and any allergies to oils or lotions, and confirms accuracy.

Send it before a first massage or share a link ahead of the visit. Knowing the client’s health, tension areas and allergies up front means a safe, tailored treatment. Customize the fields, add your branding, and embed it on your site or share a link in minutes.

Form fields

Everything the Massage Health Intake Form above collects — 11 fields across 2 pages, so you can see exactly what it captures before you make it your own.

Before Your Massage

  • Full name

    Name Icon
    Name
  • Do any of these apply?

    Multi-Select Icon
    Multi-Select
  • Please give details for anything ticked

    Long Answer Icon
    Long Answer
  • List any medications you take

    Long Answer Icon
    Long Answer
  • Where do you carry tension or pain?

    Long Answer Icon
    Long Answer
  • Preferred pressure

    Dropdown Icon
    Dropdown

Consent

  • Any allergies to oils or lotions?

    Yes/No Icon
    Yes/No
  • If yes, please specify

    Long Answer Icon
    Long Answer
  • Accuracy

    Consent Icon
    Consent
  • Email address

    Email Icon
    Email
  • Contact number

    Telephone Icon
    Telephone
Use Template Arrow Right Icon

Template FAQs

Common questions about the Massage Health Intake Form — what it captures, when to use it, and how to make it your own.

What is a massage health intake form?

A massage health intake form screens a client before their first massage, capturing conditions, medications, tension areas and allergies. It lets the therapist confirm massage is safe and tailor the treatment, protecting the client and the practice.

What should a massage health intake include?

This form captures the client’s name, whether any listed conditions apply with space for details, any medications they take, where they carry tension or pain, their preferred pressure, any allergies to oils or lotions, and a confirmation of accuracy.

When should a client complete a massage health intake?

Before their first massage, ideally ahead of the appointment. Capturing their health beforehand gives the therapist time to review it and flag anything that changes the treatment, so the massage starts safely rather than pausing to screen in the room.

Who fills out a massage health intake form?

New clients before their first massage. The form captures their conditions, medications and allergies, so the therapist knows what’s safe, where to focus, and which oils to avoid before the client is on the table.

Why does massage need a health check?

Because some conditions, injuries or medications mean certain massage should be adjusted or avoided — and some oils cause reactions. Screening up front lets the therapist treat safely, adapt pressure and technique, and choose products that suit the client.

Is this massage health intake template free?

Yes, completely free. Add or remove conditions to fit your treatments, and restyle it to your brand, then embed it on your site or share a link — no coding needed. A free Fun Forms account lets you collect responses.