Available on

Massage Therapy Client Questionnaire Mobile App

The Massage Therapy Client Questionnaire mobile app makes it easy for patients to complete a health questionnaire when they see new massage therapist. The massage session intake form helps ensure that massage therapists have all the information they need to treat a patient. The Massage Therapy client template also makes it easy to get client consent for your services before the professional massage therapy service begins.

With the electronic client intake form, any massage therapist can easily gather client feedback about previous professional massage treatments, health history and medical conditions, areas of muscular tension, use of pain medication, and current range of motions for specific joints and muscles. Each massage therapy client form is saved in your canvas Cloud account and can be shared as a PDF.

Beauty, Massage & Spa mobile forms and apps for your team

Convert your inefficient paper Questionnaires and other forms to mobile versions with GoCanvas.

Want to learn more about GoCanvas?

Request a Demo

Take a Tour

Take a peek inside the Massage Therapy Client Questionnaire Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

{{data.title}}

Included Fields

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

Date:
Name:
D.
Gender:
S.
M.
Address:
Home Phone:
Work Phone:
Occupation:
Referred by:
Have you had a professional massage prior to this visit?
Reason for therapeutic massage (major complaint):
What, if any, treatment have you had for this condition?
Is there anything that makes your condition worse?
Please note if you are currently being treated by any of the following practitioners:
Medical Doctor (MD) or Nurse Practitioner (NP)
Release:
Chiropractor
Release:
Psychiatrist
Release:
Have you had any surgery?
(If yes, please explain.
Emergency Contact Name & Relation to You:
Phone:
Desired Massage Pressure:
Sleeping Position:
...and More!