Free tool
Free massage intake form generator
Build an intake form for your practice in a few clicks. Add your practice name, choose which sections you need, and copy or download the result. No signup, works instantly.
Your intake form
[YOUR PRACTICE NAME]
CLIENT INTAKE FORM
CLIENT INFORMATION
Full name: ____________________________ Date: ____________
Phone: ____________________ Email: ____________________
Emergency contact: ____________________ Phone: ____________
REASON FOR VISIT
What brings you in today?
____________________________________________________________
Primary area(s) of concern:
____________________________________________________________
How long have you had this concern? __________________________
Pain / discomfort level (0-10): ______
HEALTH HISTORY
Do you have or have you had any of the following? (circle)
High/low blood pressure Heart condition Diabetes Arthritis
Recent surgery Fibromyalgia Skin condition Blood clots
Please explain any circled items:
____________________________________________________________
Previous injuries or areas of chronic pain:
____________________________________________________________
MEDICATIONS & ALLERGIES
Current medications:
____________________________________________________________
Allergies (including oils / lotions):
____________________________________________________________
PREFERENCES & AREAS TO AVOID
Preferred pressure: Light / Medium / Firm / Deep
Areas you'd like us to focus on:
____________________________________________________________
Areas you'd like us to avoid:
____________________________________________________________
INFORMED CONSENT
I understand that massage therapy is provided for stress reduction,
relaxation, and relief of muscular tension. I understand that the
therapist does not diagnose illness or prescribe medical treatment, and
that I should consult a physician for any concerning medical conditions.
I have disclosed all relevant health information above.
Client signature: ____________________________ Date: ____________
Therapist signature: __________________________ Date: ____________Keep intake and session notes in one place
A form is step one. TouchTrace holds each client's intake notes, every SOAP note, tagged treatment areas on a body diagram, and plain-English progress summaries together — so nothing lives on a loose sheet of paper. Voice input and saved history come with a free account.
Related tools & reading
- Massage intake form template guide — what to include and why.
- Client documentation template — how intake fits the full client file.
Frequently asked questions
- What's included in the intake form?
- Client and emergency contact details and reason for visit are always included. You can toggle on a detailed health history, medications and allergies, an informed consent section, areas-to-avoid preferences, and a health screening block — so the form fits your practice.
- Does it include a consent section?
- Yes, if you enable it. The consent block covers scope of practice and disclosure and includes signature lines for both client and therapist. Review the wording against your licensing board's requirements before using it.
- Is this a substitute for legal or professional advice?
- No. It's a practical starting template. Documentation and consent requirements vary by region and professional association, so confirm the final form meets the rules that apply to you.
- Where do intake notes go once a client fills this out?
- With a paper or text form, that's up to your own filing. TouchTrace keeps intake notes together with every session note and progress summary for each client in one secure place — so the whole history is one tap away. It's free to start.