Get the free Massage Intake Form - livewellqc

PRIMARY COMPLAINT Reason for visit When did symptoms appear? Is condition getting progressively worse? YES NO Unknown Rate the severity of your pain on a scale of 1 (the least pain) to 10 (severe)

How to fill out massage intake form

How to fill out a massage intake form:

1. Begin by filling out your personal information, including your name, contact information, and date of birth.
2. Provide details about your medical history, including any current or past injuries, surgeries, allergies, or medical conditions. This information is crucial for the massage therapist to ensure your safety and customize the treatment accordingly.
3. Indicate any areas of concern or specific goals you have for the massage session, such as relief from pain, stress reduction, or relaxation.
4. Communicate your preferences regarding the pressure of the massage, whether you prefer a light touch or deep tissue massage.
5. Answer questions about your lifestyle and daily activities, such as your occupation, exercise routine, and any hobbies or sports you participate in. This will help the therapist understand potential causes of muscle tension or imbalances.
6. Provide information about any medications or supplements you are currently taking, as they can potentially interact with certain massage techniques or products.
7. Sign and date the form to acknowledge that the information you provided is accurate and complete.

Who needs a massage intake form?

1. Individuals seeking a massage therapy session, whether for relaxation, stress relief, or targeted pain management.
2. People with specific health concerns or medical conditions that may require additional precautions or modifications during the massage.
3. Professional massage therapists who require comprehensive information about their clients to ensure safe and effective treatments.

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What is massage intake form?

The massage intake form is a document that collects personal information, health history, and preferences from clients before they receive a massage.

Who is required to file massage intake form?

Clients who are scheduled to receive a massage are required to fill out the massage intake form.

How to fill out massage intake form?

Clients can fill out the massage intake form by providing accurate information about their personal details, health history, and massage preferences.

What is the purpose of massage intake form?

The purpose of the massage intake form is to ensure the safety and well-being of the client by allowing the massage therapist to customize the massage session based on the client's needs and preferences.

What information must be reported on massage intake form?

The massage intake form must include personal information such as name, contact details, health history including any medical conditions or allergies, and preferences for the massage session.