Template library · Intake forms
Massage Therapy Intake template
Please complete before your massage session.
- 15 fields across 3 sections
- Included with MyWellOps
- Edit it, or save your own version
What’s in it
- DateDate
- PractitionerText
Contact Info
- Full nameText
- Phone numberText
- EmailText
- Emergency contact (name & phone)Text
Health History
- Other (Areas of tension or pain)Text
- Current pain/tension levelText
- Other (Do you have any of the following)Text
- Recent injuries or surgeriesText
- Areas of tension or pain (check all that apply):
- Neck
- Shoulders
- Upper back
- Lower back
- Legs
- Feet
- Do you have any of the following? (check all that apply):
- Pregnant
- Blood clots/DVT
- Skin conditions
- Recent surgery
- High blood pressure
- Allergies to oils/lotions
Preferences
- Preferred pressureChoice
- Areas to avoidText
- Goals for this sessionText
- Client signatureSignature
- Date signed (client)Date
When to use it
Send an intake form when a new client books, so their history, contact details and reasons for coming are in front of you before the first appointment rather than taken down during it.
How it works in MyWellOps
- Choose it from Documents and adjust the questions to your practice.
- Send it to the client, who completes it in their client portal.
- Their answers are kept on the client’s record, ready for the first session.
Spend less time on admin, more time with clients
Start free. Cancel anytime, and your data comes with you if you leave.
Would rather be shown? Book a 20-minute demo
- Free 1-on-1 onboarding
- 7-day free trial
- Cancel anytime