Client Intake Form
Please fill out this client intake form completely and honestly. It is very important to be honest with all information shared, especially when it comes to the questions about health and medical history.
Required Client Information:
Name:
Address:
City:
Country:
Date of Birth:
Age:
Occupation:
How did you first hear about Massage Baum?
Have you experience massage therapy before?
Which service would you like to book?
What is the purpose of your visit? How can Massage Baum best support you?
Contact Information:
Telephone-/
WhatsApp-Nummer:
E-Mail-Adress:
Which contact method do you prefer?
Health and Medical History:
Are you currently experiencing any pain or tension in your body? Do you have any injuries?
Do you have any health conditions to be made aware of? Please be honest and share all relevant information:
If yes, what are you currently doing to treat it?
Have you undergone any surgeries recently or in the past?
Do you have any allergies or other health conditions that could affect you during a massage?
Is there any other information about you or your body that you would like to share?
Policy Acknowledgement and Consent:
Schedule Your Appointment:
Please share when you would like to come. Are there specific days of the week or times (morning/afternoon/evening) that work best for you?
Space to share further concerns/expectations/boundaries?
If you'd like to share something anything else, this is the space to do so. Use this space below to share your concerns, expectations, or other information with your massage therapist.
If you don't feel comfortable writing or sharing anything right now, that's okay. When you arrive for your appointment, we'll take some time before we begin to have a conversation. You are welcome to share at any time during your massage ritual.
Danke!