Spa Intake & Health Questionnaire
Screen spa and massage clients on health, pressure and treatment goals.
- Questions
- 20
- Pages
- 4
- Layouts
- classic · card
- Conditional rules
- 3
Searches this template answers
About this template
Massage therapists and spa teams need a health picture before hands go anywhere near a client, and this questionnaire is written to be completed calmly before arrival rather than rushed in reception. It opens with contact details, an emergency contact and the treatment booked, then moves into a medical section covering blood pressure, heart conditions, recent surgery, pregnancy and trimester, diabetes, epilepsy, cancer history, varicose veins, skin conditions, injuries and current medication. Each positive answer opens a free-text box so the therapist can judge rather than guess. A goals section asks what the client wants from the session — relaxation, specific pain relief, mobility, sleep or stress — along with preferred pressure, areas to avoid, allergies to oils or nut-based products, and whether they prefer conversation or quiet. The consent block confirms the treatment has been explained, that the client will disclose any change in health, and that they accept the cancellation policy, and is signed on screen or on your reception tablet.
What this form asks
Every question is editable — rename it, make it optional, or delete it entirely.
Page 1 — Your details
- Full namerequired
- Email addressrequired
- Mobile number
- Date of birth
- Emergency contact name and numberrequired
- Treatment bookedrequired
Page 2 — Health
- Do any of these apply?required
- Any medical conditions or recent surgery?required
- Medical details
- Are you pregnant?required
- How many weeks?
- Current medication
- Allergies (oils, nuts, fragrance, latex)
Page 3 — Your session
- What would you like from today?required
- Preferred pressurerequired
- Areas to avoid today?required
- Which areas?
- Do you prefer conversation or quiet?
Page 4 — Consent
- Agreementrequired
- Client signaturerequired
20 questions in total.
Conditional logic included
- When “Are you pregnant?” is Yes, require “How many weeks?”.
- When “Any medical conditions or recent surgery?” is Yes, require “Medical details”.
- When “Areas to avoid today?” is Yes, show “Which areas?”.
Works in both layouts
Frequently asked questions
- Can I send this before arrival?
- Yes — email the link with the booking confirmation and the therapist can review answers before the client walks in.
- Is it suitable for medical massage?
- It covers standard contraindications; add clinic-specific questions or referral fields as your insurer requires.
- Can returning clients skip it?
- Send a shortened version that only asks whether anything has changed since their last visit.
- Does the signature count as consent?
- The drawn signature is stored with a timestamp against the answers, giving you a dated consent record per treatment.
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