About this template
This Client Pre-Massage Assessment Form is designed to help massage therapists and spa owners streamline their intake process. By capturing essential health history, current pain levels, and specific areas of discomfort before the client arrives, you can prepare a more effective, personalized treatment plan. This template ensures you have all the necessary information to provide safe and professional care while saving valuable time during the actual session.
The form covers critical data points including personal contact information, emergency contacts, medical history, and detailed pain tracking. It also includes sections for lifestyle factors, such as physical job duties and exercise habits, which often contribute to muscular tension. Using this digital approach replaces cumbersome paper forms, allowing you to easily organize client data in Google Sheets for quick reference before every appointment.
Key features
- Comprehensive health history and injury tracking
- Standardized pain rating and frequency assessment
- Easy-to-read layout for quick pre-session review
- Mobile-friendly for clients to complete before arrival
- Seamless integration with Google Sheets for client records
Use cases
- New client onboarding for independent massage therapists
- Standardized intake for multi-practitioner spa clinics
- Pre-appointment screening for sports massage sessions
What this form collects
- Full Name (Short answer)Please enter your legal first and last name.
- Date of Birth (Date)Format: MM/DD/YYYY
- Email Address (Short answer)We will use this for appointment reminders.
- Emergency Contact Name & Phone (Paragraph)Please provide the name and phone number of someone we can reach in case of an emergency.
- Current Pain Rating (Linear scale)On a scale of 1 to 10, how would you rate your pain today?
- Areas of Discomfort (Paragraph)Please describe where you are feeling pain or tension.
- Medical History & Medications (Paragraph)List any relevant medical conditions, recent surgeries, or medications you are currently taking.
- Have you received professional massage therapy before? (Multiple choice)This helps us understand your familiarity with different techniques.
- Informed Consent (Multiple choice)I understand that massage therapy is not a substitute for medical care and I have accurately stated my health history.
- Signature (Short answer)Please type your full name to serve as your digital signature.
FAQ
Why is a pre-massage assessment necessary?
It helps identify contraindications, specific areas of pain, and health concerns, ensuring the massage is both safe and tailored to the client's needs.
Can I add my own questions to this template?
Yes, once you generate the form, you can easily add, remove, or modify any questions directly within the Google Forms editor.
How do I share this with my clients?
You can send the form link via email, text message, or embed it directly on your website for clients to fill out when booking.
Is this form mobile-friendly?
Yes, Google Forms automatically adjust to fit any screen size, making it easy for clients to complete on their smartphones.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.