Somatic Movement Therapy Intake Form

Somatic Movement Therapy Intake Form: Build Trust and Safety from the First Contact

If you're a somatic movement therapist, trauma-informed bodyworker, or wellness practitioner working with clients on deep healing journeys, your intake process sets the tone for everything that follows. This Somatic Movement Therapy Intake Form template is designed to honor the sensitivity required when working with trauma, embodiment, and nervous system regulation—all while gathering the practical information you need to provide exceptional, person-centered care.

Why This Template Works for Somatic Practitioners

Somatic therapy is about creating safety in the body. That means your intake form can't feel clinical, invasive, or rushed. This template balances trauma sensitivity with thorough assessment, guiding clients through questions about their history, current challenges, body awareness, and boundaries in a way that feels respectful and grounding.

Whether you run a private somatic practice, teach movement classes with a therapeutic lens, or work in an integrative wellness center, this form helps you:

• Establish informed consent and touch boundaries clearly and collaboratively
• Assess body awareness and nervous system patterns without pathologizing the client's experience
• Understand trauma history with optional, compassionate language that honors what clients are ready to share
• Clarify session intentions so you can co-create a treatment plan that aligns with their goals
• Create a digital record that's accessible, secure, and easy to reference before each session

What's Included in This Template

This intake form covers:

• Contact and emergency information for safe, professional practice
• Health history and current concerns, including physical symptoms, pain, and areas of discomfort
• Movement and body awareness assessment, exploring how clients experience sensation, restriction, and embodiment
• Trauma history (optional and sensitively framed) to understand nervous system patterns and triggers
• Session goals and intentions, helping clients articulate what they're seeking from somatic work
• Touch consent and boundaries, with explicit, revisable agreements around physical contact, pacing, and communication during sessions
• Referrals and support network, understanding what other care providers are involved
• Consent and acknowledgment, confirming clients understand the therapeutic relationship and their rights

Every section uses warm, non-clinical language that centers the client's autonomy and lived experience, which is essential for trauma-informed practice.

Perfect for Somatic Movement Therapists, Bodyworkers, and Holistic Wellness Practices

This template is built for practitioners who blend movement, mindfulness, and nervous system awareness in their work, including:

• Somatic Experiencing® practitioners and trauma-informed movement therapists
• Yoga therapists working with clients recovering from trauma or chronic stress
• Dance/movement therapists and embodiment coaches
• Feldenkrais, Alexander Technique, and other somatic educators
• Integrative wellness centers offering body-based trauma healing
• Personal trainers and fitness coaches who take a trauma-sensitive, holistic approach

If your work involves helping clients reconnect with their bodies, regulate their nervous systems, or heal from trauma and disconnection, this form gives you a strong, compassionate foundation for the therapeutic relationship.

Customize, Brand, and Automate

With Paperform, you can make this template your own in minutes. Adjust the questions to match your specific modalities, add your logo and colors, embed it directly on your website, or send it as a standalone intake link. The doc-style editor makes it easy to reorder sections, add video explanations, or include grounding prompts that help clients feel safe as they fill it out.

You can also connect this form to your practice management tools:

• Send submissions to your CRM or Google Sheets for centralized client records
• Trigger a welcome email sequence via Stepper or Zapier with session prep tips and grounding exercises
• Sync with your calendar tool to confirm the first appointment and send reminders
• Export signed consent forms using Papersign for secure, legally compliant records

This means less administrative friction and more time focused on the healing work itself.

Designed for Safety, Compliance, and Client Empowerment

Trauma-informed care requires clarity, consent, and choice at every step. This form builds those principles in from the start, with language that empowers clients to share what feels safe, set boundaries, and understand what to expect. While Paperform is SOC 2 Type II compliant and GDPR-ready, please note that Paperform is not HIPAA compliant—if you're working in a context that requires HIPAA (such as certain licensed mental health or medical settings), you'll need to use a HIPAA-compliant platform for client data.

For somatic practitioners, yoga therapists, wellness coaches, and bodyworkers who aren't bound by HIPAA, this template offers a professional, secure, and beautifully designed way to welcome clients into your practice and begin the journey toward embodied healing.

Get Started in Minutes

This template is ready to use right away—no design skills or technical experience required. Just customize the questions to fit your practice, apply your branding, and start gathering intake forms that honor your clients' stories and support your trauma-informed approach. Whether you're working one-on-one, offering group programs, or building a team practice, Paperform gives you the flexibility and professionalism to grow with confidence.

Start creating safer, more connected client experiences from the very first form.