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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.

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샘플 질문

템플릿에 포함된 내용을 미리 확인해 보세요. 모든 질문은 설문 공개 전에 자유롭게 수정할 수 있습니다.

질문 13개 · 약 7분
Q01
메시지

Welcome! Before your massage, we'd like to understand your health history and goals so we can tailor your session safely. This takes about 5 minutes, and your answers stay in your confidential client file.

Q02
동의필수

Please review and confirm before continuing.

Q03
객관식필수

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
객관식필수

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
매트릭스필수

Do any of the following apply to you right now? This helps us avoid areas or techniques that could be unsafe.

7개 행 × 3개 열
  • 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
  • 외 2개
열: Yes · No · Not sure
Q06
장문형

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
객관식필수

What pressure level do you generally prefer?

  • Light, mostly relaxing
  • Medium
  • Firm
  • Deep tissue
  • It varies by area — I'll tell my therapist
Q08
의견 척도필수

How would you rate your overall stress level right now?

척도: 1 – 10
최소:Very calm최대:Very stressed
Q09
장문형

List any medications, supplements, or known allergies your therapist should be aware of (or write 'none').

Q10
AI 인터뷰

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
객관식

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
객관식

How do you describe your gender? (Optional)

  • Woman
  • Man
  • Non-binary
  • Prefer to self-describe
  • Prefer not to say
Q13
메시지

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.

포함된 기능

  • AI 후속 질문

    정형화된 설문이 놓치는 세부 내용을, 주관식 답변에 맞춰 AI가 심층 질문으로 끌어냅니다.

  • 주의력 확인 장치

    성의 없는 답변과 저품질 응답자를 걸러내는 내장 안전장치입니다.

  • AI가 작성한 문안

    문구, 질문 순서, 분기 로직까지 AI가 연구 목표에 맞춰 작성합니다.

  • 자동 리포트

    응답이 모이면 주요 주제, 인용문, 이해하기 쉬운 요약이 자동으로 작성됩니다.

다른 서비스와 비교

다른 설문 도구의 가장 유사한 템플릿을 검토했습니다. 그 도구들이 잘하는 점과, 이 템플릿이 한발 더 나아가는 지점을 정리했습니다.

이 템플릿을 선택하는 이유

  • 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 Template

A 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.

잘하는 점

  • 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

아쉬운 점

  • 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 Template

A 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.

잘하는 점

  • 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

아쉬운 점

  • 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 Template

A 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.

잘하는 점

  • 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

아쉬운 점

  • 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 Template

A 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.

잘하는 점

  • Backed by SurveyMonkey's established survey infrastructure and analytics
  • Flexible generic structure adaptable across many service businesses
  • Familiar builder for teams already using SurveyMonkey

아쉬운 점

  • 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

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