A good intake form does two jobs at once: it helps you give a safe, tailored treatment, and it shows you are a professional who takes client care seriously. For massage therapists, gathering health history and consent before the first session is part of good practice. Below is a template you can copy and adapt, with notes on what to include and why.
What a massage intake form should cover
A thorough first-visit form usually gathers:
- Contact details and emergency contact.
- Reason for the visit and any specific areas of concern.
- Relevant medical history and current conditions.
- Medication that may be relevant.
- Anything that might affect whether a treatment is suitable, such as pregnancy, recent surgery, or injury.
- Consent to treatment.
- Consent to how you store and use their information.
You do not need to ask for more than is relevant. Collect what helps you treat safely, and no more.
The template
Copy everything between the lines and adapt it to your practice and your professional body’s guidance.
[Your Business Name] — Client Consultation & Intake Form
Date: [ ]
Your details
- Full name: [ ]
- Date of birth: [ ]
- Address: [ ]
- Phone: [ ]
- Email: [ ]
- Emergency contact (name and phone): [ ]
- GP name and surgery (optional): [ ]
About your visit
- What has brought you in today? [ ]
- Are there areas you would like the therapist to focus on, or avoid? [ ]
- Have you had massage treatment before? [ ]
Health history
Please tell us if you have, or have had, any of the following, as some conditions affect which treatments are suitable:
- Heart, circulation, or blood pressure conditions [ ]
- Recent surgery or injury [ ]
- Skin conditions or allergies [ ]
- Muscular or joint conditions [ ]
- Pregnancy (and how many weeks) [ ]
- Any other condition you think we should know about [ ]
- Current medication that may be relevant [ ]
Consent
- I confirm the information above is accurate to the best of my knowledge.
- I understand the treatment being offered and consent to receiving it.
- I will inform the therapist of any change to my health before future treatments.
Signed: ___________________ Date: _______
Your information
We store your details to provide your treatment safely and to contact you about your appointments. We keep health information securely and do not share it without your consent, except where required by law. [Add a link to your privacy notice.]
A few practical notes
Update it, do not just file it.Health changes. A quick check at each visit — “anything changed since last time?” — keeps you safe and shows care. Some therapists use a shorter review form for repeat visits.
Handle health data carefully. Health information is sensitive personal data under UK data protection rules. Store it securely, keep it only as long as you need it, and have a simple privacy notice explaining what you hold and why. Your professional body and insurer will have guidance.
Let your insurer and professional body lead. Many require a consultation and consent record. Make sure your form meets whatever they specify, as it may affect your cover.
Where StudioOps fits
A paper form in a folder works until you have hundreds of clients and need to find the right one quickly, or remember to review health details before a repeat visit. StudioOps Salon keeps client records, notes, and history in one place, linked to their bookings, so the relevant information is to hand when the client is in front of you. StudioOps Salon is for beauty, massage, hair, and personal service businesses.
Next step
Adapt the template above to your professional body’s requirements and your insurer’s guidance. If you would like client records and notes kept securely alongside their bookings, take a look at StudioOps Salon.