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Massage Patient Health In-Take Form w/ Drawing Mobile App
Save time and complete this Massage Patient Health In-Take Form right on a mobile device or tablet. Perfect for massage therapy practices, the form allows patients at each appointment to enter all details such as medical history, the form of massage they desire, a drawing tool to indicate any problem areas with muscle tension, a checklist for areas you do not want massaged, surgeries, accidents, allergies, medications and more. This type of information is important for all client intake appointments to decide which massage therapy treatment is best.
Health Care & Social Services mobile forms and apps for your team
Convert your inefficient paper Patient Records and other forms to mobile versions with GoCanvas.
Take a peek inside the Massage Patient Health In-Take Form w/ Drawing 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.'}}
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Included Fields
Customize to add, remove, or edit any of the fields below.
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Name
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DOB
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Address
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State
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Zip
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Phone (Home)
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(Work)
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Emergency Contact
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Phone
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Email Address
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How did you hear about us?
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Please draw a picture of your body and circle any problem areas
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Have you received a professional massage before?
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Are there any areas of your body that you "do not" want massaged?
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Face
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Scalp
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Neck
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Upper Chest
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Shoulders
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Stomach
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Upper back
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Mid back
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Lower back
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Arms
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Hands
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Guteals
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Legs
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Feet
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...and More!
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More Information
- Creator: Team GoCanvas
- Language: English
- Country: United States of America
- Type: Patient Records
- Categories:
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