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Therapist: Time: Couples Room MASSAGE THERAPY CLIENT INTAKE FORM Name: Phone: () D.O.B: / / Street Address: City: State: Zip: Email: Emergency contact: Phone: () Occupation: How did you hear about
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How to fill out a massage therapy client intake form:

01
Start by providing your personal information, including your full name, address, phone number, and email address. This will help the therapist contact you if needed and keep your records organized.
02
Next, indicate your date of birth and gender. This information is important for the therapist to understand any age-specific or gender-specific concerns that may be relevant to your massage treatment.
03
Specify any medical conditions or injuries you currently have. This includes chronic illnesses, recent surgeries, or any acute injuries that require attention. It is crucial to disclose this information as it helps the therapist create a safe and tailored treatment plan for you.
04
Describe any medications or supplements you are currently taking. Certain medications or supplements might have an impact on your massage therapy session, so it is essential for the therapist to be aware of them. This ensures that appropriate techniques and pressure are used during the treatment.
05
State any allergies or sensitivities you have. Some individuals may have allergies to certain oils, lotions, or ingredients commonly used in massage therapy. By providing this information, the therapist can choose suitable products that will not cause any adverse reactions during your session.
06
Indicate your level of physical activity and exercise routine. This information assists the therapist in understanding your body's overall condition, flexibility, and potential muscle imbalances. It helps them determine the most effective techniques to address your specific needs.

Who needs a massage therapy client intake form?

01
Individuals seeking professional massage therapy services.
02
People with a history of medical conditions, injuries, or surgeries that may impact their treatment.
03
Those taking medications or supplements that could affect their massage session.
04
Individuals with allergies or sensitivities to certain products commonly used in massage therapy.
05
People who want a tailored massage experience based on their specific needs and physical activity level.
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Massage therapy client intake form is a document used to gather important information about a client's health history, current conditions, and reason for seeking massage therapy.
Massage therapists are required to have their clients fill out a client intake form before providing any massage services.
Clients can fill out a massage therapy client intake form by providing accurate information about their health history, current conditions, and goals for the massage therapy session.
The purpose of the massage therapy client intake form is to help the massage therapist better understand the client's needs and provide a safe and effective massage therapy session.
Information such as medical history, current conditions, allergies, medications, and goals for the massage session must be reported on the massage therapy client intake form.
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