Client Intake Form Generator

CALM HANDS STUDIO MASSAGE CLIENT INTAKE FORM Please complete this form before your first appointment. Your information is kept private and used only to provide safe service. CONTACT DETAILS - Full name: ________ - Date of birth: ________ - Phone: ________ Email: ________ - Address: ________ - Emergency contact (name and phone): ________ - How did you hear about us? Instagram / Google / Friend / Walk-in / Other MASSAGE QUESTIONS - What is the main reason for your visit today? ________ - Areas to focus on: ________ Areas to avoid: ________ - Preferred pressure: Light / Medium / Firm / Deep - Have you had a professional massage before? Yes / No - Any recent injuries, surgeries or chronic pain? ________ - Are you pregnant or could you be? Yes / No - Do you have high blood pressure, varicose veins, blood clots or a heart condition? Yes / No - Any allergies to oils, lotions or scents (e.g. nut oils)? ________ HEALTH HISTORY - Current medications: ________ - Known allergies: ________ - Conditions (tick any): Diabetes / Epilepsy / Heart condition / High blood pressure / Skin condition / Recent surgery / None - Anything else we should know to keep you safe? ________ CONSENT - I confirm the information above is accurate and I will tell Calm Hands Studio about any changes before future appointments. - I understand results vary and have had the chance to ask questions. - Cancellation policy: I agree to give at least 24 hours notice to cancel or reschedule. - I would like appointment reminders and occasional offers by text or email: Yes / No Client signature: ______________________ Date: ________ For staff use: Reviewed by ________ Date ________ Notes ________

Hi [client name], thanks for booking with Calm Hands Studio! Before your appointment on [date], please fill in our quick intake form: [form link]. It takes about 3 minutes and helps us get everything ready for you. See you soon!