Massage intake form template

Plan a safe massage before the client is on the table: what they want, where to work, how firm, and the precautions that change it.

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Have you had a professional massage before?

What would you like from this massage? (required)

Choose as many as you like

Where would you like us to focus?

Choose as many as you like

Anywhere you would rather we did not massage?

What pressure do you like?

Do you find it hard to lie on your front, back or side?

21 questions · about 4 min · logic · signature · prefill from the link

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Print it as a PDF Word version

Change the questions in Word, then print.

What you get back

Every response lands in your results the moment it is sent. Turn on email notifications and each one arrives like this, and the same answers become a row in your spreadsheet.

From PulseFormCreator

Subject New response to Before your massage

Have you had a professional massage before?: Once or twice
What would you like from this massage?: Ease tension or stiffness
Where would you like us to focus?: Neck and shoulders, Upper back
Anywhere you would rather we did not massage?: Feet, please
What pressure do you like?: Firm
Do you find it hard to lie on your front, back or side?: No

and 13 more answers

A sample email with made-up answers.

submitted_at	Have you had a professional massage before?	What would you like from this massage?	Where would you like us to focus?	Anywhere you would rather we did not massage?	What pressure do you like?
22 Sep 2026 09:41	Once or twice	Ease tension or stiffness	Neck and shoulders \| Upper back	Feet, please	Firm

Export to CSV or Excel, or send responses to Google Sheets, Notion, Airtable, Slack or a webhook. All free.

What happens after someone submits

Set it up once in the Workflows tab, and each intake reaches the therapist before the client does.

Submitted
A client sends the intake

Email me sends it to you and your therapists, with a PDF of the answers to keep with the booking.
You need to ask something

Reply from their response in Results, and their answer comes back into the same thread before the session.
They come back for more

Their intake stays on their People timeline, so a later visit starts from what they told you.

Set this up when you use the template

What this form asks, and why

The last column shows how often real massage intake forms ask for it.

Question	Why it is there	Real forms
Have you had a professional massage before?	A first-timer gets draping and check-ins explained.	11 of 17 forms
What would you like from this massage? Required	Relaxation and a stiff neck are different massages.	11 of 17 forms
Where would you like us to focus?	A list instead of a body outline, which is hard to mark on a phone.	5 of 17 forms
Anywhere you would rather we did not massage?	Feet, face, a scar: said before the session, not during it.	6 of 17 forms
What pressure do you like?	Only 6 of 17 forms ask, though it shapes the whole hour.	6 of 17 forms
Do you find it hard to lie on your front, back or side?	A yes means side-lying or extra support, set up in advance.	3 of 17 forms
Full name Required	Matches the form to the booking.	17 of 17 forms
Mobile Required	For a running-late text or a changed time.	16 of 17 forms
Email Required	Reminders and rebooking.	14 of 17 forms
Emergency contact (name and relationship)	Asked on 7 of 17 forms, for a client who feels unwell after the session.	7 of 17 forms
Emergency contact number	Optional, like the name.	7 of 17 forms
Is the person having the massage under 18? Required	Replaces the date of birth asked on 15 of 17 forms: age only decides who consents.	15 of 17 forms
Parent or guardian’s name Required Only when “Is the person having the massage under 18?” is Yes	Shown for under-18s, who need a parent’s consent.	3 of 17 forms
Does any of this apply to you at the moment? Required	Conditions that change where, how firmly or whether to massage. Some end on a check-in screen.	15 of 17 forms
Anything else your therapist should know?	The only free-text health box: a safety check, not a history.	5 of 17 forms
Changes Required	So one intake covers later visits.	8 of 17 forms
Not medical treatment Required	Therapists do not diagnose or prescribe, and 11 of 17 forms say so.	11 of 17 forms
Draping and conduct Required	Draping, stopping at any time and what ends a session, in one checkbox.	6 of 17 forms
Cancellations Required	Your notice period and fee. Link your policy.	5 of 17 forms
Health answers Required	Health answers are sensitive, so the client agrees to you keeping them.	3 of 17 forms
Signature Required	Confirms the answers are true, like the declaration on 12 of 17 forms.	14 of 17 forms

What we left out

A list of medications. Asked on 15 of 17 forms. The precautions list asks about blood thinners, which change how firmly to work; the free-text box takes the rest.
Doctor’s details and medical history. Doctor details on 8 of 17 forms; family history and an “AIDS or STD” question on 1 of 17 forms each. None of it changes the massage.
Occupation and postal address. Each asked on 12 of 17 forms. Nothing is posted, and work comes up on the table.
A checklist of nearly 60 conditions. AMTA’s printable form has one; 13 precautions keep this one short enough to finish on a phone.

What 17 real massage intake forms ask

How many include each field, from forms organizations use today. Part of the Form Field Index.

Name 17 of 17
Phone number 16 of 17
Date of birth 15 of 17
Medical conditions 15 of 17
Medications 15 of 17
Allergies 14 of 17
Diabetes 14 of 17
Email address 14 of 17

Read September 2026 · US 9, UK 7, Canada 1 · Sources

Advanced Holistic Health LLC · massage and holistic therapy practice, US
Mindful Massage & Wellness · massage therapist, US
Indy North Massage · massage clinic, US
All Is Well Holistic Spa & Massage · massage spa, US
Freedom Chiropractic Health Center (massage therapist) · chiropractic clinic, massage service, US
Hanson Chiropractic Center · chiropractic clinic, massage service, US
Massages4u · massage therapist, UK
Steve Holder Sport Massage Therapy · sports massage therapist, UK
NC Teaching Spa · college teaching spa, Canada
Target Therapies · massage therapy practice, UK
The Osteopathic Practice (Jane O'Connor & Associates), Leamington Spa · osteopathic practice, sports massage service, UK
A'INE Complementary Therapies · complementary therapist, UK
Jake's Place Men's Barbering Lounge and Spa · men's barber and spa, US
AL!VE · wellness center, US
Somatic Massage Therapy & Spa · massage and spa, US
NW Sports Massage Therapy · sports massage therapist, UK
Revive Massage · massage therapist, UK

How the form changes as people answer

Most people see a shorter form. These questions and screens only appear when an answer calls for them.

When “Is the person having the massage under 18?” is Yes

shows “Parent or guardian’s name”
When “Does any of this apply to you at the moment?” includes one of 5 answers

shows the “Thanks, Nadia. Your therapist will check in first.” ending

Make it yours

Send it with the booking

Add ?name=Nadia Haddad to the link in your confirmation and the form opens with her name filled in.
Match the precautions to your training

Edit the list to the contraindications your association or insurer teaches. Keep “None of these” last: it clears the other boxes.
Keep it to your clients

Turn on Password protection under Settings → Access and limits, and give the password with the booking.

Good practice and the law

This is general information, not legal advice. Rules differ by country and state, so check anything important where you operate.

US
PulseFormCreator is not HIPAA compliant. HIPAA covered entities, such as practices billing health insurance electronically, should use a compliant system. CMS, HIPAA covered entities
UK
Health answers are special category data under UK GDPR and need a condition such as explicit consent. ICO, special category data
Australia
Health details are sensitive information under the Privacy Act, and complementary therapists are covered whatever their turnover. OAIC, small business

Questions about this template

Why does it ask about blood clots and pregnancy?

Both change the massage: a clot is a reason not to work the area, and pregnancy changes how the client lies.

Does a checked precaution mean no massage?

No. Some end on a check-in screen: the therapist may adjust the massage or ask for a doctor’s go-ahead.

How often should clients fill it in?

Once. The health-changes checkbox covers later visits; send it again after an injury or a year.

Can I use it for sports or remedial massage?

Pick “Sports or remedial” above the preview: sport, level, event date, and how long and how much it hurts.

Which form do you need?

Not quite the job? One of these may fit, or browse all intake forms.

Personal training client intake form
For personal training: a readiness screen and training goals.
Release of liability form
For a signed release of liability, which this intake does not include.
Coaching intake form
For coaching or consulting, with no health questions.

Start with the massage intake form template

Open it in the editor and match the precautions to your training.