Medium

Available on

Apple Android Windows

Massage and Bodywork Intake Form Mobile App

The Massage and Bodywork Intake Form mobile app provides a detailed client intake form perfect for massage therapists or those who manage massage services, This helpful mobile app documents the following: Client Information, Massage History / Session Information, Previous History, Terms and Captures Client Signature. In the rare occasion that an error occurs while using the GoCanvas client on a mobile device, it is very easy to submit the error logs to GoCanvas so that we can analyze them and help track down any issues. It's a great tool to use to provide a smooth and easy massage experience and treatment.

Come check out all of our popular android massage apps.

  • Lendlease
  • The Cooperative
  • PG&E
  • Red Bull
  • Mirvac

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Take a peek inside the Massage and Bodywork Intake Form Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico date

    Date

  • Ico textbox

    Name

  • Ico multiline

    Address

  • Ico textbox

    Phone

  • Ico textbox

    Occupation

  • Ico date

    Date of Birth

  • Ico textbox

    Emergency Contact Name

  • Ico textbox

    Emergency Contact Phone

  • Ico textbox

    Referred By

  • Ico textbox

    Email

  • Ico dropdown

    Have you ever received a professional massage?

  • Ico date

    Date of last massage

  • Ico multiline

    What result do you want from your massage sessions?

  • Ico multiline

    List any exercise activities.

  • Ico dropdown

    Are you currently under the care of a health care practitioner?

  • Ico multiline

    If yes, specify purpose:

  • Ico multiline

    List current medications and purpose:

  • Ico statictext

    (Include year and treatment received)

  • Ico multiline

    Injuries/accidents/illnesses still affecting you:

  • Ico multiline

    Surgeries:

  • Ico statictext

    Please mark any of the following that you now have or have had.

  • Ico statictext

    Musculoskeletal

  • Ico checkbox

    Bone or joint disease

  • Ico checkbox

    Tendonitis / Bursitis

  • Ico checkbox

    Arthritis / Gout

  • Ico checkbox

    Jaw pain (TMJ)

  • Ico checkbox

    Lupus

  • Ico checkbox

    Spinal Problems

  • ...and More!

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