Massage Health History Template

Medical History Intake Form

INSTANT DIGITAL DOWNLOAD

People looking for "extras" do not want to document their blood clot history, list their implanted devices, disclose their anticoagulants, and initial a consent form that explicitly states the session is non-sexual in nature. They just don't. A thorough clinical intake form is the least glamorous boundary tool you own — and one of the most effective.

This three-page form covers everything: critical screening flags, comprehensive medical history across nine body systems, allergies and product sensitivities, medications and supplements, MVA history, surgical hardware, informed consent, and minor treatment authorization. It looks like what it is — a document from a healthcare professional.

Because that's what you are.

You get both files:

The Word doc is fully editable — drop in your business name, credentials, logo, and license number, adjust the language to match your style, and make it yours in under ten minutes. The PDF gives you a clean, print-ready version to preview exactly what you're working with before you change a thing.

Generic by design. Bulletproof by intention. Built to work in any state, any setting, any specialty.

⭐⭐⭐⭐⭐

"I sent this to a new client who had been weirdly vague on the phone. He never filled it out. Never heard from him again. Honestly? Best outcome possible. Meanwhile my actual clients think I'm incredibly thorough and professional. Win-win. Ten out of ten, would screen creeps again."

— S.T., LMBT, North Carolina

None of my courses are submitted for CE approval — meaning no hours for your renewal, but also no ethics course you've taken six times and could probably teach yourself by now. What you're getting is real training, real content, and zero padding. Your license renewal will survive without it. Just solid, practical information worth your time and your investment.

Created by Julie Barton, MS, LMBT #6489, ATC-Ret. | Dynamic Bodywork LLC