Wellness Intake Form Template

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A wellness intake form collects essential client health information before massage therapy, facials, body wraps, acupuncture, or reflexology appointments. It gathers health conditions, skin sensitivities, pressure preferences, and treatment consent in one structured form. Unlike a general appointment request, this form ensures practitioners have the clinical detail needed to deliver safe, personalized care.

Use Cases

  • A massage therapist sends this form before a new client's first session to document health conditions, recent surgeries, and preferred pressure so the treatment plan is ready on arrival.
  • A day spa uses the form during online booking to collect skin sensitivity and allergy details ahead of facial and body wrap appointments, reducing chair-side intake time.
  • An acupuncture clinic routes completed forms to the treating practitioner before each appointment, flagging pregnancy disclosures and focus-area requests for review.

Ideal For

  • Licensed massage therapists responsible for documenting client health history and treatment consent before each session.
  • Spa coordinators and estheticians responsible for collecting skin sensitivity and allergy information prior to facial or body treatments.
  • Holistic health practitioners and acupuncturists responsible for screening clients for contraindications before providing hands-on care.

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