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A Sample Massage Therapy Intake Form (That You Can Actually Use)

October 15, 2015 Author: Allissa Haines

Raise your hand if you were using your massage school's sample intake form for the first several years of your massage practice! It's embarrassing to admit, but I did that. Several years. Eventually my 4th generation copy was nearly unreadable and I finally had to step up, battle with a word processing program, and make my own. I searched and downloaded a handful of samples from the internet and set about making my own.

It was a huge pain in the rear. Turns out, when I'm starting from scratch I'm kind of picky.

My priorities

I want my standard intake form to be 2 pages or less, including my cancellation policy. Any more than that and the client will grow weary, filling out the form will take too long, and the whole first massage experience will be bothersome from the start. (I do ask clients to fill out the form ahead of their first visit, but that doesn't always happen. And for all my love of technology, I haven't jumped into an online form yet.)

Of course, if you work with a clientele that requires a more detailed intake, yours may be longer. (I have a different intake form for people with cancer or cancer history.)

I want a gender neutral figure of a body. As a woman, I hate when forms default to male. And I'm not organized enough to keep 2 version of the intake form around. Also, because most of the obviously male or female graphics are a little more specific than they need to be for my purposes.

I want the email address line to be followed by a permission request for email marketing.

I want a space for a new client to note the referral source, and give me permission to thank that referral source.

My Form

So we're giving you the form I came up with. Because you work hard enough, yo. This PDF is available here

You'll probably want to design your own form eventually. But it's okay to take some time to figure out what you need, and this'll get you started.