Get Client Intake Form - Wix.com

Completing the CLIENT INTAKE FORM is an essential step for receiving personalized massage services at Blooming Massage. This guide will walk you through each section of the form, ensuring you provide the necessary information in a clear and easy manner.

Follow the steps to accurately complete the intake form.

1. Press the ‘Get Form’ button to obtain the intake form and open it in your preferred editor.
2. Begin by entering your full name in the designated field. Ensure that the spelling is correct for proper identification.
3. Fill in your date of birth (DOB) next. This information is important for health and age considerations.
4. Provide your current address including the city, state, and zip code to ensure accurate communication.
5. Enter your contact number and email address where you can be reached for appointments and updates.
6. Indicate your occupation, as this might help the therapist to understand your potential stressors or physical needs.
7. List an emergency contact along with their phone number and your relationship to them to be prepared in case of unexpected situations.
8. Provide your physician's name and contact number in case medical consultation is necessary.
9. Detail any relevant medical history, including current health conditions and medications you are taking. This information is critical for safe treatment.
10. Indicate any specific health conditions from the provided checklist that apply to you; include an explanation for any marked conditions to give further context.
11. Specify any areas on your body that you prefer not to have massaged. Clear communication about your preferences is vital.
12. Reflect on how you learned about Blooming Massage and document this information in the given field.
13. Before submitting the form, ensure that all information is accurate and concise. Then, create your signature and date the form to confirm authenticity.
14. Finally, save your changes, and choose to download, print, or share the completed form as needed.

Complete your CLIENT INTAKE FORM online today for a personalized experience at Blooming Massage.