Follow the steps to accurately complete your intake form.

1. Click the ‘Get Form’ button to access the intake form and open it in your online editor.
2. Begin filling out the personal information section. Enter your full name and date of birth, which helps in identifying your records and ensuring your safety during the massage.
3. Provide your address, including street, city, state, and zip code. This information is important for administrative purposes, including communication and appointment reminders.
4. Fill in your contact details, including your work phone, home phone, and cell phone numbers. Make sure these are accurate so the clinic can reach you if necessary.
5. Enter your email address to receive notifications and confirmations regarding your appointments.
6. Indicate how you heard about the massage services by specifying the referral source in the 'Referred by' section.
7. Answer the exercise-related questions. Specify whether you engage in exercise and Frequency: then elaborate on the types of exercise you participate in.
8. Detail any other daily activities that contribute to your overall wellness or could influence your massage treatment.
9. List your primary care physician’s name and telephone number. This enables communication regarding any pre-existing health conditions.
10. Include the name and contact number of your chiropractor, if applicable.
11. State whether the massage practitioner may contact your primary physician or chiropractor by circling 'Yes' or 'No.'
12. Disclose any medications you are currently taking by listing them in the designated field. Additionally, list any medications taken on the day of the appointment.
13. Describe your preferred methods for stress or pain relief to help the practitioner understand your needs.
14. Evaluate and describe any pain related to traumatic experiences or discomfort, along with indications on the provided diagram.
15. Answer whether you have received professional massage services before and provide your thoughts on previous experiences.
16. Express how you would like to feel following your massage, helping ensure the service meets your expectations.
17. Indicate any areas of your body that you would prefer not to be worked on during your session.
18. Review and check any existing health conditions relevant to your massage treatment by marking an 'X' in the applicable boxes.
19. Use the last section to inform the practitioner of any vital information they need to know prior to starting your session.
20. Confirm that all information provided is accurate by signing and dating the document. If the client is under 18, ensure a parent or guardian signs as well.
21. Once you have completed all sections, save your changes. You may download, print, or share the finished form as required.

Start filling out your CA Peak Performance Massage Client Intake Form online today for a smooth and personalized experience.