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Massage Therapy Client Intake Patient Information Name: Date of birth: Address: City: State: Zip: Primary phone: Secondary phone: Email address: Occupation: Emergency contact: Phone: Relationship:
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How to fill out massage intake form

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How to fill out a massage intake form:

01
Start by providing your personal information such as your name, address, phone number, and email address. This information is important for the massage therapist to contact you and keep track of your session records.
02
Specify any relevant medical conditions or injuries you may have. It is crucial to disclose any health issues, allergies, or medications you are taking to ensure a safe and effective massage.
03
Indicate the type of massage you would like to receive. This could be a relaxation massage, deep tissue massage, sports massage, or any other specific type that aligns with your needs and preferences.
04
Communicate your goals and expectations for the massage session. Whether you seek pain relief, stress reduction, improved flexibility, or other benefits, it is essential to share these details with the massage therapist so they can tailor the session accordingly.
05
Mention any areas of your body that require special attention or areas that you prefer the therapist to avoid. This helps the massage therapist focus on your individual needs and ensure a comfortable and personalized experience.
06
Sign the form, indicating that you have provided accurate information and that you understand the terms and conditions of the massage therapy practice.
07
Keep a copy of the filled-out intake form for your records and bring it with you to your scheduled massage appointment.

Who needs a massage intake form:

01
Anyone seeking professional massage therapy services can benefit from filling out a massage intake form. Whether you are a first-time client or a regular customer, providing the required information ensures that the massage therapist has a comprehensive understanding of your health, preferences, and goals for the session.
02
Massage therapists require intake forms to create a personalized treatment plan for each individual. These forms not only help in assessing any potential contraindications but also assist in tailoring the massage to address specific concerns and achieve optimal results.
03
Intake forms are especially important for individuals with medical conditions, injuries, or allergies as it enables the massage therapist to adapt the treatment accordingly, ensuring safety and avoiding any adverse reactions.
04
Even if you do not have any specific health concerns, filling out an intake form helps in establishing a baseline of your overall well-being and allows the massage therapist to track your progress over time.
Remember, filling out a massage intake form accurately and honestly enhances the effectiveness of your massage therapy experience and promotes your overall well-being.
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