Get Massage Client Health History Form

Filling out the MASSAGE CLIENT HEALTH HISTORY FORM online is an important step in ensuring you receive the appropriate massage therapy services suited to your individual health needs. This guide provides step-by-step instructions to help you navigate the form with ease and confidence.

Follow the steps to accurately complete your health history form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in your name, street address, today’s date, date of birth, age, city, state, and zip code. Ensure all information is accurate and up to date.
3. Enter your email address, home phone number, cell phone number, occupation, employer, and work phone number. This information is critical for communication and follow-ups.
4. Indicate your gender and marital status, and provide the name of the person who referred you to the service.
5. Complete the emergency contact section by providing the contact's name, relationship to you, and phone number.
6. Review the list of medical conditions and mark (X) any current conditions you have, and (P) for any conditions you have had in the past. Provide additional details in the space provided.
7. Document any other medical conditions not listed above, and include a history of fractures and surgeries, specifying the description and dates.
8. Indicate whether you are currently under the care of a health professional and, if applicable, the condition for which you are receiving care.
9. If you take medications, mark yes and then list the medications along with the reasons you are taking them.
10. Select your exercise level from the available options.
11. Indicate whether you have received professional massage therapy before and outline your goals for the visit along with any major or minor complaints.
12. Read and consent to the terms outlined regarding the massage therapy and provide your signature, date, and witness name.
13. Once you have completed the form, save your changes. You may download, print, or share the form as needed.

Complete your MASSAGE CLIENT HEALTH HISTORY FORM online to ensure a tailored massage therapy experience.