Pregnancy massage intake form

Massage therapy has long been used to help alleviate the physical and emotional discomforts of pregnancy. Pregnancy massage is a specific type of massage that is tailored to the needs of a pregnant woman. It is often used to help reduce stress, relieve pain, and improve circulation.

2 minutes to complete


If you are pregnant, you can get a pregnancy massage once your doctor gives you the approval.


Questions for Pregnancy massage intake form




The answer should be a text input.


The answer should be a date input.

Start time

The answer should be a text input.

End time

The answer should be a text input.

How did you hear about us?

The answer should be a text input.

Are you currently pregnant?

The answer should be a single choice:
  1. Yes
  2. No

If yes, how many weeks pregnant are you?

The answer should be a text input.

Do you have any medical conditions we should be aware of?

The answer should be a text input.

Do you have any allergies?

The answer should be a text input.

Do you have any injuries or areas of pain?

The answer should be a text input.

Is there anything else you would like us to know?

The answer should be a text input.

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Here are some FAQs and additional information
Pregnancy massage intake form

What are the benefits of pregnancy massage?

Pregnancy massage can offer many benefits including relief from back pain, neck pain, and headaches. It can also help to improve circulation and reduce stress and anxiety.

Is pregnancy massage safe?

Yes, pregnancy massage is generally safe. However, it is important to consult with your healthcare provider before receiving any massage, especially if you have a history of high blood pressure, heart disease, or are pregnant with twins.

How often should I get a pregnancy massage?

There is no one-size-fits-all answer to this question. However, most women find that weekly or bi-weekly massage is beneficial.

What should I expect during a pregnancy massage?

Your massage therapist will likely use a variety of techniques, including Swedish massage, deep tissue massage, and trigger point therapy. They will also use pillows and cushions to support your body and help you.

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