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Questions to Include for A Massage COVID Intake Form

A Village of Resources· Fresh Out Of Massage School· Running A Massage Therapy Practice

In this Post: As we gear up to return to work, we need to start thinking about questions to include for a massage COVID intake form!

Massage COVID Intake Form

While it is impossible to mitigate all risks involved with returning to work, we can eliminate some by instituting a new COVID intake form. Not only does this help you screen your clients and give you a right to refuse service, it also gives your client a moment to pause and reflect on the reality of how they are feeling, their possible exposure to the virus, and their risk factors. 

So often in life, we charge through and forget to take stock of how we are truly feeling. Depending on how connected your clients are, they may completely miss a warning sign of COVID because they haven’t taken a moment to scan their bodies. An intake form allows them this pause. 

Take a moment to brainstorm all the possible questions you think are important to know about your client’s symptoms, proximity to COVID, and risks. Here is a list of my suggestions to get you started. 

Questions to Include for A Massage COVID Intake Form

1. In the last 24 hours, have you had a fever of 100°F or above? 

2. Do you currently, or in the recent past had, any respiratory or flu symptoms (such as fever, chills, sore throat, cough, muscle aches, or shortness of breath)? 

3. In the last 14 days, have you been in contact with anyone who has been diagnosed with COVID-19 or has coronavirus-type symptoms? 

4. In the last two weeks, have you traveled anywhere outside of the state? 

If yes, where: ___________________________________________ 

5. Have you experienced a loss of sense of taste or smell? 

6. Do you fall into the vulnerable individual category for any of the following; over 65, chronic lung disease or severe asthma, a serious heart condition, immunocompromised, pregnant, or determined by a health care provider to be at high risk? 

The following questions are specific to a new aspect of COVID-19 involving blood coagulation. 

7. Can you exercise to get your heart rate and respiratory rate up without any problem? 

8. Have you had a new onset of muscle aches and pain since the emergence of the virus? 

9. Have you seen any new marks, rashes, spots, bumps, or other lesions on your skin? 

Brainstorm

Now brainstorm your own questions to include for a massage COVID intake form. You may want to combine it with the liability waiver. Many therapists believe that a liability waiver won’t stand up in a court of law, and maybe that’s true. But you better believe that I am still going to have my clients sign one! My feeling is that any additional means to attempt to protect yourself is prudent. So maybe it won’t stand up in court, BUT perhaps it will. And for me, perhaps makes it worth it! 

My suggestion would be to have clients fill out this form before every appointment. One day they may have no symptoms, but the very next, they might have the slightest hint of a sore throat. Also, remember the moment of pause? The chance for the clients to reflect on what is truly going on in their bodies. This is going to be important moving forward! We want our clients to continually be assessing how they feel and be honest and open in their communication with us about changes. 

I know many places simply have clients attest to the fact that nothing has changed since the last time they received massage. But I kinda don’t think that’s good enough. I know it is a pain for clients to fill out paperwork, but we are in a new world. In this new world, we want to be taking all the precautions we can. Therefore, my suggestion is to have your clients fill out this form for EVERY MASSAGE they receive. 

How to Create An Online Intake Form

There are many ways out there to deliver intake forms, but my favorite method is through the website JotForm.com. Here you can easily create your own customizable form that is entirely online. They even have an app you can install on your phone for easy access to your forms and your client’s results. As a solo practitioner, you can probably get away with their free version as you get 100 submissions per month. It really is pretty slick how smooth this platform works! 

Whether you use JotForm or another platform, you will want to take some time to develop an intake form that addresses the new concerns we are currently facing. As much as I would love for things to be back to normal, they aren’t. And therefore, we must adjust. 

Are there any questions you felt like I missed? I’d love for you to share what you added to your COVID intake form! Please share in the comments! 

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