Massage Intake Form: What to Include (With a Free Template)

A good massage intake form tells you, before your hands are on the table, whether today's massage is safe, what the client wants from it, and what they've agreed to. Most massage intake form templates online are form-builder demos: a list of fields with no explanation of why each one is there or what to do with the answers. This guide goes through each section of a massage therapy intake form, gives you wording you can copy, and covers when to update it and how to get it to clients before their first visit.

It's a practical guide, not legal advice. Massage is regulated differently in each state, province and country, and the rules on consent and health records can change. Check your version against your licensing board, regulatory college or professional association.

What to include in a massage intake form

1. Client details and emergency contact
2. Reason for the visit and goals
3. Massage history and preferences, including pressure
4. Health history
5. Contraindication screening questions
6. Medications and allergies
7. Consent to treatment
8. Policies: cancellations, late arrivals and conduct
9. Privacy and communication preferences
10. Signature, date and form version

The template below follows that order. Copy it into your forms tool or a document, and delete anything that doesn't apply to the work you do.

The massage client intake form template, section by section

1. Client details and emergency contact

• Full name, and the name you'd like us to use
• Pronouns (optional)
• Date of birth
• Phone, email and mailing address
• Emergency contact: name, relationship and phone number
• Primary care provider or family doctor (optional)
• How did you hear about us? (optional)

Date of birth matters because you need to know whether you're treating a minor, which usually means a parent or guardian gives consent. The emergency contact is for emergencies only. If a client wants you to be able to discuss their care with someone, ask that separately in the privacy section.

2. Reason for the visit and goals

• What brings you in today?
• What would you like to get from this session? (for example: relaxation, less stiffness, recovery after training, help with a specific area)
• Are you in pain or discomfort right now? Where? On a scale of 0 to 10, how strong is it?
• Is this related to a recent injury or accident? If so, when did it happen?

If your form supports it, add a body diagram where clients mark areas to focus on and areas to avoid. "My back" means different things to different people, and a marked diagram saves five minutes of questions.

3. Massage history and preferences

• Have you had a professional massage before? When was the last one?
• What type of massage are you booking? (relaxation, deep tissue, sports, prenatal, other)
• Pressure preference:
  • Light
  • Medium
  • Firm
  • Not sure: I'd like the therapist to check in
• Any areas you don't want massaged? (for example: feet, face, scalp, abdomen, glutes)
• Draping: is there anything you'd like us to know about how you're covered during the session?
• Do you have sensitivities to oils, lotions, nut oils or scents?
• Preferences during the session: quiet, conversation, music, room temperature

Ask about pressure and areas to avoid in writing, then confirm them out loud. Some clients won't say "that's too much" on the table, but they'll tick "light" on a form.

4. Health history

Keep this to what you need for safe treatment. A checklist with "yes / no / not sure" and a space for details works well:

• Heart or circulation problems, including high blood pressure
• History of blood clots or deep vein thrombosis
• Diabetes
• Epilepsy or seizures
• Cancer, current or past treatment
• Osteoporosis or other bone and joint conditions
• Arthritis
• Nerve conditions, numbness or tingling
• Headaches or migraines
• Skin conditions
• Surgery in the past two years: what and when
• Implants, pins, plates or pacemakers
• Pregnancy, and how many weeks
• Anything else you think we should know

Add a free-text question at the end: "Is there anything about your health that you'd like to discuss in person rather than write down?" Some clients would rather tell you face to face, and it shows you're not asking for more than you need.

5. Contraindication screening questions

Health history covers the long term. Contraindication screening is about today, so it belongs on every visit, not just the first one:

• Do you have a fever, cold, flu or any other infection today?
• Do you have any rashes, open wounds, cuts, bruises or sunburn?
• Have you had an injury, sprain or strain in the past 72 hours?
• Have you had surgery, a procedure or an injection recently?
• Do you have any swelling, redness, warmth or pain in your legs?
• Have you started any new medications since your last visit?
• Are you pregnant, or could you be?
• Has anything about your health changed since your last appointment?

A "yes" doesn't automatically mean you can't treat. It means you ask follow-up questions and decide whether to go ahead, adapt the session, postpone it or ask for medical clearance, based on your training and your regulator's guidance. Write down what you decided and why in your treatment notes.

6. Medications and allergies

• Current medications, including over-the-counter, supplements and anything taken for pain
• Do you take blood thinners?
• Allergies: medications, latex, oils, lotions, nuts or other

Medications can affect how a client responds to pressure, so ask about blood thinners and pain medication specifically. If you use a practice management system, record allergies somewhere you'll see them before every session, not only on the original form.

7. Massage consent form wording

Many therapists put consent at the end of the intake form. Others use a separate massage consent form, which is easier to update on its own. Either way, the consent should explain in plain language what the client is agreeing to. Adapt this sample wording:

I understand that massage therapy is provided for [relaxation, stress relief and relief of muscle tension]. My therapist does not diagnose illness or disease, prescribe medication or provide medical treatment, and massage is not a substitute for medical care.

Before treatment begins, my therapist will explain the proposed treatment, what it may help with, possible side effects such as temporary soreness, alternatives, and what may happen if I don't have it. I will have the chance to ask questions before I agree.

I can ask for the pressure or techniques to be changed, or for the session to stop, at any time.

I have answered the health questions above honestly and will tell my therapist about any changes to my health.

Two things to check against your own rules:

• What makes consent "informed." Ontario's regulator, for example, sets out what a therapist must cover before consent counts, including the nature of the treatment, benefits, risks, alternatives and the right to stop or change it (CMTO Standard of Practice: Consent). Your regulator may word it differently.
• Sensitive areas. Some regulators require separate written consent before treating sensitive areas. Ontario's standard, for example, requires written or electronic consent before every treatment of the upper inner thighs, chest wall or breasts, and for the glutes at the first visit of a treatment plan, with verbal consent each time after that. If your regulator requires this, keep it as its own signed section rather than a line buried in the general consent.

A signed form doesn't replace the conversation. Talk through the plan before the session, check in during it, and record what was agreed in your notes.

8. Policies

• Cancellation and no-show policy, including the notice period and any fee
• Late arrivals: whether the session ends at the booked time
• Conduct: that the session will be stopped if the client behaves inappropriately
• A checkbox: "I have read and agree to these policies"

9. Privacy and communication preferences

• A short statement on how you collect, store and protect health information, with a link to your full privacy notice
• May we contact you by text? By email? May we leave voicemails?
• Is there anyone we may speak to about your appointments or care? Name and relationship

What this section needs to say depends on your privacy law. In the US, for example, a provider is only a HIPAA covered entity if it sends health information electronically for standard transactions such as insurance claims, so many cash-pay massage practices aren't covered. State privacy laws can still apply, and treating the form as confidential health information is the right standard either way. If you are covered, our guide to HIPAA-compliant intake forms covers what the form and your storage need.

10. Signature, date and form version

• Client signature (or parent or guardian for minors, with their name and relationship)
• Date
• Form version, for example "Intake v3, January 2027"

The version number tells you which wording a client agreed to, which matters when you change your consent or policies later.

Ask only for what you need

Every question you add is information you have to protect, and a longer form for clients to abandon. Go through each field and ask: what would I do differently if I knew this?

Some regulators now spell this out. Ontario's college requires massage therapists to collect only the personal health information reasonably needed for safe and effective treatment, to offer more than one way to provide it (verbal, written or electronic), and not to ask about risks already managed by routine infection control, such as HIV or hepatitis C (CMTO Standard of Practice: Collecting Personal Health Information). Even if you work elsewhere, it's a useful test for any form.

When to update your massage intake form

There are two kinds of updates: the client's answers, and the form itself.

The client's answers:

• Every visit: a short health check before each session, using the screening questions in section 5. It can be a one-page form or a conversation you record in your notes.
• Every 12 months, or after a big change: have the client review and re-sign the full health history. Pregnancy, new diagnoses, surgery and new medications are all reasons to do it sooner.

The form itself:

• When you add a service, such as prenatal massage, cupping or work on areas that need separate consent.
• When your regulator, association or privacy law changes its requirements.
• When you change your cancellation or other policies.
• When clients keep misunderstanding a question, or you keep asking the same follow-up in person. That's a sign the form needs rewording.

Each time you change the form, update the version number and date, and keep the old version so you know what earlier clients agreed to.

How to send the intake form before the first visit

Getting the form done before the client arrives gives you time to read it, spot anything that needs a conversation, and start the session on time instead of watching someone fill in a clipboard.

1. Send it with the booking confirmation, so clients can do it while the appointment is on their mind.
2. Send a reminder a day or two before if it isn't done yet.
3. Make it work on a phone. Most clients will open it from a text message or email. Short sections, tick boxes and a signature they can draw with a finger all help.
4. Pre-fill what you already know, such as name, phone and email from the booking, so clients only type what's new.
5. Offer an alternative. Some clients prefer paper, or to go through it with you in person. Keep a printed copy and some extra minutes for them.
6. Read it before the session, not during it. Flag anything from the health history or screening questions you want to ask about.
7. Store it with the client's record. A form sitting in your email inbox or a shared drive is hard to find later and hard to keep secure.

In Caspen, you can build your intake form with the online forms builder, send it by SMS or email, request signatures, and pre-fill the client's details. Responses are saved straight to the client's record, and clients can also complete forms in the client portal. See how it fits a massage practice on our massage therapy software page.

Start with a form you can change

Your massage intake form doesn't need to be perfect on day one. Start with the template above, cut what you don't need, check the consent and privacy wording against your own regulator, and adjust it as you see how clients answer it.

If you'd like to send it online and keep every response with the client's record, start a free Caspen trial.