Free Client Pre-Massage Assessment Form Template

Client Pre-Massage Assessment Form

Please fill out this form to help us tailor your massage to your needs.

Date

    Name

      Phone Number

        Email

          Do you have any of the following conditions?

          Select all that apply:

            • High Blood Pressure

            • Diabetes

            • Heart Condition

            • Arthritis

            • Recent Injury or Surgery

            • None

            Are you currently experiencing pain or discomfort?

            If yes, please describe

              Allergies

                Preferred pressure level for massage

                  Specific areas of focus or concern (e.g., back, shoulders)

                    Assessment Form Templates @ Template.net

                    Thank you for completing this form!

                    If you have any questions, please feel free to ask before your session.

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