Q01
メッセージ
すべてのテンプレートHealthcare & Clinical
Massage Therapy New Client Intake Assessment
A pre-session intake for massage and bodywork clients that captures health history, contraindications, areas of tension, and treatment goals so therapists can plan a safe, effective session. An AI follow-up interview digs into the client's primary concern — onset, triggers, and what's already been tried — so therapists walk in with context instead of a blank form.
設問の例
テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。
全13問・約7分
Q02
同意必須
Please review and confirm before continuing.
Q03
選択式必須
What's the main reason for today's massage?
- General relaxation
- Chronic pain relief
- Recovery from a specific injury
- Stress or anxiety reduction
- Sports performance or recovery
- Prenatal comfort
- Improving flexibility or range of motion
Q04
選択式必須
Which areas are feeling tense, sore, or painful today? Select all that apply.
- Neck
- Shoulders
- Upper back
- Lower back
- Hips or glutes
- Legs
- Arms or hands
- Feet
Q05
マトリクス必須
Do any of the following apply to you right now? This helps us avoid areas or techniques that could be unsafe.
7行 × 3列
- High blood pressure or a heart condition
- Currently pregnant
- Recent surgery or injury (within the last 6 weeks)
- Blood clots or a history of deep vein thrombosis
- Skin conditions, rashes, or open wounds
- ほか2件
列: Yes · No · Not sure
Q06
自由回答（長文）
If you're dealing with a specific pain, injury, or medical condition, describe it here — when it started, what makes it better or worse, and anything your therapist should know.
Q07
選択式必須
What pressure level do you generally prefer?
- Light, mostly relaxing
- Medium
- Firm
- Deep tissue
- It varies by area — I'll tell my therapist
Q08
オピニオンスケール必須
How would you rate your overall stress level right now?
スケール: 1 – 10
最小:Very calm最大:Very stressed
Q09
自由回答（長文）
List any medications, supplements, or known allergies your therapist should be aware of (or write 'none').
Q10
AIインタビュー
Focus on the client's main reason for the visit and the area they flagged as most tense or painful: ask when it started, what triggers or worsens it, and what they've already tried (self-care, physical therapy, other treatments) and how well it worked. If they marked 'Not sure' on any health-history item, gently clarify what that means before the appointment. Close by confirming what a successful session would feel like to them.
Q11
選択式
What's your age range? (Optional — helps us tailor techniques appropriately.)
- Under 18
- 18–29
- 30–44
- 45–59
- 60–74
- 75 or older
- Prefer not to say
Q12
選択式
How do you describe your gender? (Optional)
- Woman
- Man
- Non-binary
- Prefer to self-describe
- Prefer not to say
Q13
メッセージ
Thank you for sharing this with us! Your therapist will review your intake before your session to plan the safest, most effective approach for you. This information is kept in your confidential client file.
含まれる機能
AIによる深掘り
自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。
注意確認設問
急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。
AIが作成する設問文
文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。
自動レポート
回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。
他ツールとの比較
ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。
このテンプレートを選ぶ理由
- Includes a dedicated AI follow-up interview step that probes the client's flagged main concern and most tense area — onset, triggers, what's been tried — before the therapist ever sees the intake
- Combines structured screening (contraindication matrix, pressure preference, tension-area selection, stress rating) with open-ended health history so therapists get both quick-scan and narrative context
- Optional age/gender demographic questions are clearly marked optional and framed around technique tailoring, not just data collection
- Ends with a clear consent step and a closing message setting expectations that the therapist reviews the intake before the session
Jotform
Massage Therapy Client Intake Form TemplateA standard fielding-ready intake form built on Jotform's drag-and-drop form builder, likely covering health history and consent fields typical of massage intake paperwork. It benefits from Jotform's large template ecosystem and integrations, but reads as a static document-style form rather than an interactive interview.
優れている点
- Ready-to-use template within a mature, widely-used form builder
- Likely supports e-signature and PDF export common to Jotform's healthcare templates
- Large surrounding template library for related intake variants
物足りない点
- No adaptive follow-up questioning — clients can't be probed further on their stated pain or concern
- No per-response quality scoring or automated report generation for therapists
- No voice-based interview option
Typeform
Massage Therapy Client Intake Form TemplateA conversational, one-question-at-a-time intake form in Typeform's signature style, which likely makes it feel friendlier than a typical medical form. It's a fixed-path template, however — logic branching exists but there is no genuine AI-driven follow-up that adapts based on what the client actually writes.
優れている点
- Polished, conversational UI known for higher completion rates than dense static forms
- Simple logic jumps possible based on multiple-choice answers
- Easy to embed on a therapist's booking site
物足りない点
- No adaptive AI interview to dig into onset/triggers of a specific complaint
- No automated quality scoring of open-text responses
- No voice AI interview option or auto-generated clinical-style report
SurveySparrow
Massage Therapy Intake Form TemplateA conversational survey template positioned in SurveySparrow's healthcare category, presumably covering health history and preferences in a chat-like format. Like Typeform, its conversational feel is a UX layer over static question logic rather than true adaptive probing of client answers.
優れている点
- Chat-style format designed to feel approachable for a wellness intake
- Sits within a dedicated healthcare template category, suggesting some domain tailoring
- Likely supports basic skip logic
物足りない点
- No adaptive AI follow-up interview or voice interview option
- No automated per-response quality scoring
- No transparent, published prompt methodology or auto-generated report for the therapist
SurveyMonkey
Client Intake Form TemplateA generic client intake form template, not specifically built for massage or bodywork practices, so a therapist would need to customize it substantially to cover contraindications, tension areas, and pressure preference. It's a static survey suited to broad service businesses rather than a purpose-built massage intake.
優れている点
- Backed by SurveyMonkey's established survey infrastructure and analytics
- Flexible generic structure adaptable across many service businesses
- Familiar builder for teams already using SurveyMonkey
物足りない点
- Not massage-specific out of the box — lacks built-in contraindication or tension-area screening
- No adaptive AI or voice interview to explore a client's specific complaint
- No automated quality scoring or auto-generated per-client report
よくあるご質問
「Massage Therapy New Client Intake Assessment」テンプレートにはどのような設問が含まれていますか？
すぐに使える設問が13問含まれており、最初の設問は次のとおりです：「Welcome! Before your massage, we'd like to understand your health history and goals so we can tailor your session safely…」・「Please review and confirm before continuing.」・「What's the main reason for today's massage?」。すべての設問は上でプレビューでき、自由に編集できます。
このアンケートの回答にはどのくらい時間がかかりますか？
回答者は通常、13問を約7分で回答し終えます。
テンプレートは編集できますか？
はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。
このテンプレートは無料で使えますか？
はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。
公開の準備はできましたか？
このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。
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