A massage intake form is a client-completed health and consent document that massage therapists use before the first session to screen for medical conditions, identify contraindications, capture treatment goals, and document informed consent. It protects both the client and the therapist and is recommended by the American Massage Therapy Association (AMTA) as a foundational element of safe practice.
A complete intake form is the foundation of safe, personalized massage therapy. It surfaces medical history that affects how the therapist works — recent surgeries, blood-thinning medications, pregnancy, cardiovascular conditions, or skin disorders — and provides written, signed consent that documents the client agreed to treatment after being informed of its scope. AMTA's Standards of Practice emphasize knowledge of pathophysiology and contraindications, and the intake form is how that knowledge gets applied at the chair-side level.
Practices customize their intake forms for the modalities they offer, but a well-designed form covers the categories below. With Zentake, each section can include conditional logic so clients only see questions that apply to them.
Client demographics
Full legal name, preferred name, date of birth, address, phone, email, and emergency contact.
Referral and goals
How the client found the practice and what they hope to achieve — pain relief, stress reduction, injury rehabilitation, prenatal care, or general wellness.
General health history
Current physician, primary care provider, recent surgeries or hospitalizations, allergies, and a list of current medications (especially blood thinners, opioids, and topical analgesics).
Medical conditions screen
Cardiovascular conditions, hypertension, diabetes, cancer history, autoimmune conditions, blood-clotting disorders, neurological conditions, fibromyalgia, recent fractures, and infectious skin conditions.
Pregnancy and reproductive health
Pregnancy status, trimester, complications, and recent childbirth or pelvic procedures when applicable.
Pain and musculoskeletal concerns
Body diagram or text fields where the client marks areas of pain, tension, or limited range of motion, along with onset, severity, and aggravating factors.
Lifestyle and stress factors
Activity level, sleep patterns, occupational ergonomics, and recent or chronic stressors that may inform the session.
Treatment preferences
Preferred pressure (light, medium, deep), modalities of interest (Swedish, deep tissue, sports, prenatal, hot stone, lymphatic), areas to avoid, and draping preferences.
Contraindication acknowledgment
Statement that the client has disclosed all relevant medical information and understands that some conditions may require physician clearance before massage.
Informed consent and policies
Scope of practice, draping standards, communication expectations during the session, cancellation policy, and acknowledgment that massage therapy is not a substitute for medical care.
Signature and date
Electronic signature with timestamp finalizes the consent.
1. Send the form before the appointment. Pre-visit completion gives the therapist time to review medical history and flag any concerns before the client arrives.
2. Review responses before the session. Look for red flags: blood thinners, recent surgery, uncontrolled hypertension, contagious skin conditions, or pregnancy complications that require modification or physician clearance.
3. Confirm verbally at the start of the session. A short verbal check-in confirms the form is current, surfaces anything the client forgot to write down, and re-establishes consent.
4. Update at every visit. Health status, medications, and goals change. A brief update form before each session keeps the record current.
5. Store securely. Intake records contain protected health information when the practice handles insurance or maintains medical records. Treat them with HIPAA-grade security.
6. Reference during treatment planning. The intake form is not paperwork to file away — it is the source of the treatment plan and should be revisited during charting.
Licensed massage therapists (LMTs) in solo practice, wellness centers, and spas.
Medical massage and clinical massage practices that integrate with chiropractic, physical therapy, or pain management.
Sports and orthopedic massage practitioners working with athletes and post-surgical clients.
Prenatal and postpartum massage specialists who require pregnancy-specific screening.
Mobile and on-site massage businesses delivering massage in homes, offices, or events.
Day spas and wellness centers standardizing intake across multiple therapists.
Absolute contraindications include uncontrolled bleeding disorders, deep vein thrombosis, contagious skin infections, recent fractures at the treatment site, and certain post-surgical states. Local or relative contraindications — areas to avoid or pressure to modify — include varicose veins, recent injuries, pregnancy (with modality-specific adjustments), uncontrolled hypertension, and active cancer treatment without oncologist clearance. The intake form is where these conditions are identified before the session begins.
| Aspect | Paper Intake | Zentake Digital Intake |
|---|---|---|
| Pre-visit completion | Limited; usually filled out in the waiting room | Sent via SMS or email; completed before arrival |
| Legibility | Handwriting and missed fields are common | Typed responses with required-field validation |
| Conditional logic | All clients see every question | Clients see only the questions relevant to them |
| HIPAA compliance | Requires locked physical storage | Encrypted storage with audit logs |
| Updates between visits | Re-print and re-file | Quick update form between sessions |
| Therapist prep time | Reviewed minutes before the session | Reviewed and flagged before client arrival |
Pre-visit SMS and email delivery — Send the intake form when the appointment is booked so it is complete before the client arrives via pre-visit patient intake.
Conditional logic — Hide pregnancy questions for clients who indicate they are not pregnant, surface deeper screening only when red-flag conditions are reported, with customizable online forms.
Electronic signatures — Capture HIPAA-compliant electronic signatures for informed consent.
In-clinic tablet completion — Walk-ins and last-minute clients fill out intake on a tablet using in-clinic tablet intake.
HIPAA-compliant storage — Encrypted in transit and at rest, with audit logs, through HIPAA-compliant forms.
Practice management integration — Route completed intake to the chart through EHR and practice management integrations.
Chiropractic Intake Form — Comprehensive musculoskeletal intake for chiropractic practices.
Acupuncture Intake Form — Traditional Chinese Medicine intake including constitutional assessment.
Physical Therapy Evaluation Form — Functional assessment for PT initial evaluations.
Wellness Consultation Form — Lifestyle and integrative health intake.
Prenatal Massage Intake Form — Pregnancy-specific massage screening.
What is a massage intake form?
It is a health history, treatment goals, and consent document that clients complete before their first massage session. It helps the therapist identify contraindications, personalize the session, and obtain documented informed consent in line with AMTA Standards of Practice.
What information should a massage intake form collect?
Demographics, emergency contact, current medications, medical conditions, surgeries, pregnancy status, areas of pain, treatment goals, pressure preferences, and signed informed consent. Forms can be tailored for prenatal, sports, medical, or spa modalities.
Are massage intake forms required by law?
Requirements vary by state and licensing board. Even where intake forms are not explicitly mandated, AMTA recommends them as a standard of practice, and most professional liability insurers expect them. They are essential for documenting informed consent.
How often should clients update their massage intake form?
The full intake form is typically completed at the first visit and updated annually or when health status changes. Most practices use a brief update form at every visit to capture changes in medications, injuries, or goals.
Do massage intake forms need to be HIPAA compliant?
Massage practices that bill insurance, work as part of a covered medical practice, or maintain medical records are subject to HIPAA. Even practices not formally covered should treat health information with HIPAA-grade security to protect client privacy and meet state confidentiality laws.
What are common contraindications to screen for on the intake form?
Deep vein thrombosis, uncontrolled bleeding disorders, contagious skin conditions, recent surgeries or fractures, pregnancy (with modality-specific adjustments), uncontrolled hypertension, and active cancer treatment without medical clearance.
Can clients complete the massage intake form online before arriving?
Yes. Digital intake delivered by SMS or email before the appointment lets the client take their time at home and gives the therapist a chance to review and flag any concerns before the session starts.
1. American Massage Therapy Association. Standards of Practice. amtamassage.org/about/news/standards-of-practice
2. American Massage Therapy Association. Client Intake Form Template. amtamassage.org/resources/forms-templates/client-intake-form
Last updated: May 2026.
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