How to Reduce Massage Client No-Shows

Many massage therapists share the dream of building their own successful practice. But even with good client management and scheduling processes, most massage businesses will inevitably have client no-shows, late arrivals and cancellations. These no-shows and last-minute cancellations are frustrating and they can easily cost a massage business thousands of dollars per year. This is a common problem that most self-employed service professionals have to deal with at some point.

How can I reduce massage client no-shows and cancellations? There are several ways that massage therapists can reduce the number of client no-shows and last-minute cancellations in their practice. The best strategies and tactics include sending clients automated appointment reminders, writing a no-show policy and educating clients about it, requiring payment at time of booking, creating efficient scheduling processes, and improving customer relationships.

In this article, you’ll learn the details of how to implement these no-show strategies as well as some tips on how to handle missed appointments when they do occur. You will also learn how to write an effective no-show policy. There’s a sample no-show policy (PDF) that you can download to use in your massage business or as a template to write your own.

Client no-shows can be an expensive problem

Client no-shows and last-minute cancellations can cost your massage business more than you might think. The main reason these are a problem is that they leave a gaping hole in your schedule. This opening can be very hard to fill on short notice. And without a client on the table, you’re not getting paid. No shows and late cancellations will undermine your efforts to be efficient and productive. This problem affects not only massage therapy business owners, but also independent contractors and therapists who work as an employee.

No shows can become a big problem if they happen on a regular basis. For example, if you charge $70 for a 1-hour massage and have three missed appointments per week, that’s a revenue loss of $210 per week. This can quickly add up to a loss of $880 per month, or $10,920 per year! So you can see that even cutting your no-show rate in half would still have a big effect on your income.

Let me take a step back to briefly define two main types of missed appointments. A client no-show is simply when a client with a scheduled appointment does not show up, and did not contact you to cancel or reschedule their appointment. You don’t know if they are on their way and just running late, or if they forgot, or if they just decided not to keep their scheduled appointment.

A last-minute cancellation is almost as bad. These clients call to cancel or reschedule their appointment in the hours leading up to their scheduled appointment time. This can cause frustration for therapists and make it challenging to stay productive because you’ve already blocked that time out of your day. You may have even turned away other clients who wanted that appointment time because it was previously booked. When a client cancels at the last minute, it can be difficult to find another client who is willing and able to take the newly available time slot. Even if the client who cancelled wants to reschedule for later that day or another day this week, it will disrupt a busy therapist’s personal and business schedule.

How to calculate your client no-show rate

To calculate your client no-show rate, simply divide the number of no-shows by the total number of appointments over a set period of time. You can use this formula to calculate your no-show rate for the day, week, month or year. Doing this calculation every month (rather than by day, week or year) would likely produce the most useful and accurate information for most small massage practices. If you have a really busy practice, then you may want to track your weekly no-show rate.

Example: a massage business had 80 appointments scheduled for the month. 7 no-show clients completely missed their appointment without contacting you. 11 clients contacted you on the day of their appointment to cancel or see about rescheduling the day or time.

• No-show rate = 8.75% (7 ÷ 80)
• Late cancellation rate = 13.75% (11 ÷ 80)

It’s a good idea to calculate and track these metrics every month to make sure your numbers are improving. When analyzing your business metrics, you may want to also look at where your no-shows and late cancelations are coming from. Is it primarily from first-time clients? If so, then applying some of the strategies below can help. Improving how you schedule and communicate with first-time clients, informing them of your policies, and requiring full or partial payment to book their appointment can be especially useful.

You may also find other similarities in your no-show clients that could indicate a problem. For example, you could discover that your late evening or early morning clients are the ones who tend to cancel or no-show most often. Or you could find that clients who found you through a specific marketing campaign or referral source are most likely to no-show. Be sure to also ask your clients WHY they missed their appointment. A simple survey can help you identify problems in your processes.

Why do massage clients miss their appointment?

Massage therapy is usually something that people look forward to. So why would clients miss their scheduled appointment? Understanding these reasons can help you take the right steps to minimize this problem in your practice.

These problems could be due to individual client issues, but they could also result from something that needs to be corrected within the massage practice. Examples of practice management problems include failure to remind clients of their appointments, lack of missed visit policies or inadequate client education on these policies.

Three basic reasons for missed appointments:

1. Client truly forgot. This person was looking forward to their appointment however it slipped their mind when the time came. This no-show can be frustrating for the therapist and the client, but using automated reminders is a good way to minimize this problem.
2. Client remembered but chose another priority. This could result in a no-show or a cancellation. Of course there are things that are more important than keeping a massage appointment. But aside from an actual emergency, a client who doesn’t have the courtesy to call you is probably not an ideal client for your practice.
3. Client remembered but physically couldn’t get there. This reason for missing appointments may be more common for some massage businesses than others. For example, a practice that serves clients with physical mobility issues or transportation issues will run into this problem more often. Some therapists overcome this by offering mobile massage services as well.

Frequent cancellations and no-shows could also mean that you’re setting appointments with clients who don’t really value the services you offer. Not all clients will be a good fit for your practice. When a client values your service and places a high priority on it, they are less likely to miss their appointment.

10 Strategies to reduce client no-shows and late cancellations

While no strategies can completely eliminate missed appointments from a massage business, there are a few strategies that you can implement that will dramatically reduce the number of no-shows, last-minute cancellations and late arrivals. Applying these strategies will help you avoid a lot of problems as your practice grows.

1. Send appointment reminders

Reminding your clients of their appointment date and time will not only benefit your massage business, but your clients will appreciate it as well. The best way is to use automated reminders that are scheduled to be delivered at pre-determined times. Automating your reminders saves you time and increases consistency. Many online massage booking apps or scheduling software providers integrate this feature. You can set up an automated phone call, text or email to go out at preselected times. And if you can provide reminders that get clients more excited about their appointment, even better.

It is ideal to give each client multiple reminders about their appointment date and time. Confirming each appointment at 48-hours prior will give you the opportunity to fill this appointment time in case the client says that they need to cancel. Sending another automated confirmation again at 2-hours prior will remind clients who may have forgotten or got sidetracked. Keep in mind that some clients may need additional reminders. You could even require clients to reply to your reminder to confirm that they will be there.

Find out each client’s communication preferences when they book their first appointment, and keep this in mind when deciding what kind of appointment reminders to send. Sending email reminders to someone who rarely checks their email won’t do any good. And sending text reminders to a client who only uses a land line won’t help either.

It is important to be consistent with your appointment reminders. It can confuse clients if they are used to receiving a reminder, and then this time you don’t call or text to remind them. They may second-guess their memory of setting the appointment in the first place. Or they may think that you forgot about their appointment. Also, if you decide to give reminders, do it for every client. This will make the process easier. Educate your clients that they will get a reminder, and they can choose the contact method. And for every client that schedules an appointment while at your office, you should give them an appointment reminder card.

2. Review your scheduling process

Another strategy to reduce client no-shows is to examine your scheduling process for potential problems. There may be a simple issue that you can easily correct. For example, you could be communicating with clients in a way that is too tentative. This may inadvertently leave clients feeling like they can cancel at any time and you’re ok with it. You want clients to understand that canceling or rescheduling an appointment at the last minute affects not only you, but your other clients. Especially if the client booked a highly sought-after appointment time that other people wanted too.

Make sure your process of initial contact with new clients includes educating your clients on your no-show and cancellation policy. If your massage marketing strategy directs prospective clients to call you to schedule an appointment, make sure you explain your fees and policies during the conversation. If your marketing directs new clients to your website to view your services and book an appointment online, make sure you include a clear explanation of any charges that they will incur for a missed appointment. Ensure that your policies and procedures easy to find and understand.

In general, the best time to schedule a current client’s next appointment is right after a massage. At this time, the value that you provide for them is fresh in their mind. However, this can present a problem if they want to schedule their next appointment way in the future (e.g. 3 months from now). It is hard for many people to know what their schedule will be like 3 months from now. Also, getting a massage may have moved down the list of their priorities by then.

*The longer the the gap between scheduling and the actual appointment, the greater the likelihood that the client ends up calling to cancel or reschedule. To prevent this, you may want to limit how far into the future you allow clients to schedule. The one exception to this is if you really are that busy and have no openings for 3 months. In this case the client will be more likely to keep their appointment because they know if they miss it, they will not be able to reschedule for months (see strategy #6).

3. Create a No-Show Policy

One of the documents that you should create when you start a massage business is a No-Show Policy. This policy is a set of guidelines, rules and penalties that a massage practice uses to manage clients who intentionally or unintentionally miss their scheduled appointment. An effective no-show policy will help discourage clients from missing their appointment. A no-show policy may also include a business’s rules regarding late arrivals, cancellations and rescheduling.

The benefits of creating a No-Show and Cancellation Policy include:

• Avoiding confusion about how you will handle no-shows, late cancellations or requests to reschedule
• Fair and consistent client management practices
• Clear client expectations
• Fewer disruptions in your schedule

4. Require pre-payment

Requiring clients to pre-pay for their appointment gives them an incentive to show up for their appointment and abide by your business policies. This strategy is especially useful for scheduling new clients who may feel like they have nothing to lose if they just skip the appointment. It can also be a useful tactic to require any frequently absentee clients to prepay when booking their appointment.

Along with requiring new clients to pay in advance, it is helpful to have clients complete some or all of their intake documentation online, prior to their arrival. A client that takes the time to complete their health history form online and review/sign any policies that you require is demonstrating their commitment to keep their appointment. This will also save time when they arrive for their first appointment. Plus, it will give you a heads-up about their current condition and any contraindications for massage that they might have. As your practice gets busy and fills up with clients, getting this information ahead of time can help increase efficiency.

5. Remove appointment barriers

Remove barriers that can prevent clients from keeping their appointment. This is especially important for clients in your target market. Here are a few ideas on how you can apply this strategy:

• Survey clients in your target market to make sure that you are making yourself available at times that are best for them. You may find that these clients really need certain times of the day, or days of the week. Make sure your business hours align with your clients’ schedules.
• When someone schedules an appointment, watch for signs of hesitation or concern about the day or time. If there are no other times available that week, you could open a better time slot for this client, or recommend that he or she schedule the following week, at a time that better fits their schedule.
• Location can be another barrier. Having a massage office that is too far from your clients, or takes too long to get to, is a more challenging barrier to overcome. If this is the cause of many of your no-shows or cancellations, then you may need to market your practice to people who are closer, or consider moving your office. You could also offer mobile services if you have a lot of clients that live in a neighboring town.

6. Limit your availability

When you’re just starting to build a practice, it can be useful to control what days and times you make yourself available for client appointments. Batching your client treatment time is an effective time management strategy that will help you allocate time for other tasks, such as marketing or working another job.

Limiting the days and/or hours you offer for appointments will help these open time slots fill up sooner. It will encourage clients to schedule further in advance, and it will discourage cancellations. Once these appointment times start filling up, you can gradually make yourself available at additional days and times. This uses the principle of scarcity, which basically states that people fear being unable to get what they want. Scarcity raises the perceived value of something. However, it is still important to make sure that your availability aligns with your ideal clients’ preferences. You’ll likely find that about 80% of your clientele prefer appointment times during 20% of regular business hours and days (Pareto Principle).

Limiting your availability also sets better boundaries between work time and personal time. This time boundary is good for the mental, emotional, and physical health of self-employed massage therapists. Not having designated appointment times will feel like being on-call all the time. *You must respect and value your own time before you can expect anyone else to.

7. Show your appreciation

A simple but often overlooked strategy to reduce client no-shows is to simply show your appreciation. Having clients who consistently show up on time is something to be grateful for. So be sure to express your gratitude and thank your clients regularly. You will make them feel genuinely appreciated.

Something as simple as saying “thank you” can go a long way towards nurturing client relations. Clients are influenced by your words, decisions and actions whether intentional or unintentional. Showing appreciation and gratitude is a good way to build a respectful and mutually beneficial therapeutic relationship.

Showing respect for your clients’ time can also help. If clients feel that you value their time, they will be more likely to value yours. Try to minimize the amount of time your client has to wait to get an appointment. Also minimize any waiting time when they arrive for their appointment. It is important that you are ready to start on time. If a client is early, and the room is ready and you are able to, then go ahead and start the client session.

8. Reward clients for showing up

Consider rewarding client behaviors such as consistently showing up on time for appointments or referring new clients to you. Rewards will reinforce desired actions by using a behavior modification technique known as operant conditioning. Essentially you’re training your clients to show up on time. Every reward system, from customer loyalty programs to the gold stars that you used to get on your grade school exams are examples of this technique. A similar interesting phenomenon is that pointing out a desired behavior tends to increase it. You’ve just reinforced this client’s belief that following through with their commitments is part of who they are.

Even small rewards work too! For example, after a client shows up on time for 5 or so scheduled appointments, you can reward the client with $25 off their next massage, or provide an add-on service for free (e.g. foot salt scrub, use of hot stones, or 30-minute treatment extension). These are examples of positive reinforcement.

Negative reinforcement can work too, but tread lightly with this. Years ago I had a barber who worked out of his home. He was really good at his job, but if you were more than 5 minutes late he would lock his door. He had a loyal clientele and maintained a busy schedule. So this strategy worked for him. I was only late once.

9. Book clients who value your services

You can reduce the number of no-show clients by marketing your services to people who already appreciate the benefits and value of massage therapy. Remember that one characteristic of an Ideal Client is that they place a high value on the services that you offer. These clients prioritize their scheduled appointment with you. So that when other opportunities or demands on their time arise, they schedule those things around their appointment with you.

It can also help to continue educating current clients about other benefits of massage that they may not be aware of. For example, a client may schedule a few massage sessions due to back or neck pain. Once their pain has been relieved, they may want to cancel any remaining sessions because their original motivation for seeking massage is gone. However, this client may have other indications for massage that he or she is not aware of. So educating clients on other cumulative benefits could turn this person into a long-term repeat customer.

A lot of cancellations and no-shows could be a sign that you’re working with the wrong people. Consistently working with people who don’t value your work leads to an unfulfilling work life, and decreased happiness and excitement about what you do. Don’t waste your time working with (or marketing to) people who don’t care.

10. Schedule your least dependable clients last

One more practical strategy is to schedule your least reliable clients as your last appointment for the day. This strategy won’t reduce no-shows, and obviously can’t be used for new clients because you don’t yet know how reliable they are. But using this strategy means that if the client does miss their appointment, at least you can just call it a day and go home. You won’t have to stick around for your next appointment, try to move your next client up, or try to find someone on your waiting list who can come in.

How to handle client no-shows and last-minute cancellations

Missed appointments are inevitable, regardless of how well you implement the no-show strategies listed above. Fortunately, there are a few approaches you can try that may reduce your losses, and potentially salvage the appointment.

It’s important to follow-up with every client who misses their scheduled massage appointment. Your goal should be to understand why they missed their appointment, and also reschedule them for a new appointment. And depending on your business policies and how you handle payments, you may even need to collect a missed appointment fee. Check out our list of things successful massage therapists do differently.

*When following up about a missed appointment, be sure to remain courteous and tactful, and avoid guilt trips or being critical. Because let’s be honest, there are many things in life that are more important then getting a massage. And besides, if the client truly forgot, then they probably feel bad enough about it already. Following up can help you build rapport with the client, and hopefully prevent losing what could be a loyal long-term client.

Dealing with client no-shows and late arrivals

Initially, the approach to handle a late arrival or a no-show is the same, since you don’t know if the client is just running late or won’t be coming at all. Creating an effective no-show follow-up protocol means you won’t need to wonder what to do each time a client doesn’t show up on time for their massage appointment. Developing a consistent follow-up protocol is also helpful if you plan on hiring a receptionist. Contacting the absentee client by texting and/or calling their cell phone will likely be the most effective way to reach them. But it’s still important to refer to the individual client’s communication preference that you discovered on their first appointment. Here are a few ideas for a no-show follow-up protocol:

• At 5 minutes late: call the client to confirm that they are on their way. Try not to make assumptions about why they aren’t there yet. If they are stuck in traffic or just running late, there’s a good chance that they are already frustrated and upset with themself. If the client completely forgot, then you and the client will need to determine the best course of action. Maybe they can still come in for a 30-minute massage if they are close by. If you cannot reach the client, then try again in 10 minutes.
• At 15 minutes late: If you were unable to reach the client on your first attempt, give it one more try at 15 minutes after their scheduled time. Unless they are almost there, it is probably too late to salvage the appointment now. But you still need to figure out what happened, get them rescheduled, and discuss any applicable no-show fees. You could create an email to text message template for missed appointments to send at this time: “Sorry we missed you. If you’d like to reschedule, please call me at…”

Decide ahead of time how long you will wait for a client before you call someone on your waiting list or begin working another task.

You can’t control when a client arrives, but you can control what time the massage ends.

Dealing with last-minute cancellations

Cancellations and requests to reschedule can be almost as frustrating as no-shows, especially if the client waits until the day of their appointment to contact you. But at least when a client calls and gives you a few hours notice, you may be able to make use of the new gap in your schedule.

It can be helpful to create your own productivity plan, or internal policy to help you maintain productivity if you have a cancellation. Some things that you could address in your plan include:

• Make a waiting list of clients who are nearby, willing and able to come in for a massage on short notice. This works especially well once you get booked out several weeks in advance. Those clients who really want a sooner appointment but were unable to get one may jump at the chance for a last minute massage. You could also consider offering a discount for clients who will come in on short notice. You could even send a group text to everyone on this stand-by list, and the give the appointment to the first person to call you back.
• Have your to-do list handy so that you can jump right into working on another task if a client cancels at the last minute or no-shows. This could be personal errands, taking time for self-care, or completing tasks for your massage business like washing laundry, writing SOAP notes, or marketing.

Keep track of your missed appointments and late arrivals. Take the time every month to compile and analyze this data to see how big of an issue this is for your practice. If it turns out that a high percentage of your clients are not showing up at their scheduled appointment on time, then you might have an underlying cause that you need to figure out. If this is the case, you’ll need to closely examine your entire scheduling process and how you communicate with your clients. It could also be that your marketing is not attracting the right clients for your practice (people who value your services). A business mentor can help you identify the source of the problem and come up with some solutions.

How to write a no-show policy for your massage business

Effective policies will help a business function smoothly and solve problems quickly when they do arise. Business policies reduce the potential for conflict that could strain client relationships. Just like a contract or partnership agreement, a policy sets guidelines to inform all parties how an issue will be resolved. A good no show policy conveys reasonable consequences for client actions that disrupt normal business operations. It should be clear and easy to remember.

Make sure that every new client reads over your no-show policy and signs it on his or her initial visit. Also, make sure that current and future clients can review your policies at any time. Most massage businesses post their client policies on their website, as well as posting a copy at their front desk or other conspicuous places. Keep in mind that your policies may need to change to your business as it grows and you find out what works best for your practice. A brand new practice may want more lenient terms, whereas a busy practice may need to be more firm.

Also consider creating an internal policy of what you will do if certain situations arise. For example:

• What if you have to cancel on short notice. Will you: reschedule their massage at the same price? Reschedule at no charge? Call in a stand-in therapist? Refer your clients out to another massage therapist? Or give your clients some options? It helps to plan ahead.
• What will you do if you forget an appointment or accidentally double book? How will you make it up to the client? Would you offer the same recourse to a new client as you would a long-term client?

Components of a client no-show policy

Cancellation window. Provide a cancellation window when clients can cancel or reschedule their appointment without any fees or penalties. 24 hours is a reasonable cancellation window for most massage businesses. This allows clients some flexibility while still providing the therapist enough time to fill an opening if someone needs to cancel or reschedule. And if you are sending reminder calls or texts 48 hours before their appointment, this still gives the client 24 hours to contact you without incurring a fee.

Fees & penalties. Determine what fees and penalties you will charge for clients that miss their cancellation window. There are many ways to structure this, so you’ll want to think carefully about your options. Consider making your no-show fee higher then your late cancellation fee, because you want people to call even if cancelling at the last minute, instead of giving you no notice at all.

• No-show fee. This fee could be a percentage of your hourly rate or a fixed dollar amount. For example, if a no-show client missed a 1-hour appointment, your fee could range from 25% to 100% of your hourly rate. A fixed dollar amount may be easier if you charge different prices for different services (e.g. Swedish vs deep tissue), or if you offer different durations of treatment. *Your fee needs to be high enough to discourage missing appointments, but low enough to avoid loosing good clients. You could also structure this on a sliding scale, to be more lenient for their first missed appointment. For example:
  • 1st no-show or late cancellation fee = $25
  • 2nd no-show or late cancellation fee = $50
  • 3rd no-show or late cancellation fee = $75
• Setting penalties. You may also choose to establish some penalties that discourage clients from missing their appointment. This could include requiring clients who miss an appointment to provide full or partial prepayment to book future appointments. Or you could restrict them from booking an appointment for 6 months if they exceed a certain number of missed appointments in a 12-month period.

The fees and penalties in your No-Show Policy will need to be customized for your unique business and clientele. The best policies use a combination of these approaches while avoiding getting too complicated. Being either too lenient or too excessive each have their pros and cons. And a combined approach of rewarding clients when showing up on time, and using fees for negative reinforcement will result in an efficient practice with few no-shows.

Late arrivals. Include details about how late arrivals will be handled. This is also a balancing act. It is good to include some leniency, which is easy for a new practice because you won’t be booked solid yet. But you also don’t want this to become your clients’ expectation, because your time is valuable too, even if your practice isn’t full yet.

New clients. First-time clients who you haven’t built a relationship with yet are more likely to no-show than a repeat customer. For this reason, many massage practices require new clients to pay for their appointment at the time of booking. You could choose to waive this requirement for new clients that were referred by a current client. Therapists who use online booking may also choose to require new clients to call for a client consultation and schedule their appointment over the phone. This extra step is useful to screen new clients to make sure that your massage or bodywork services are right for the client. You may discover that the client currently has contraindications for massage such as an acute injury.

Let your practice policies reflect your principles.

Policies are many, Principles are few,
Policies will change, Principles never do.

John Maxwell

Communicating and enforcing your massage policies

Communicating a new massage policy to your clients is perhaps the most important step of initiating a no-show policy. Clients cannot be expected to follow your rules if they don’t know them. Trying to enforce a policy that a client doesn’t know about is a sure way to lose a client and get some bad reviews online. Have each new client review your no-show policy during the intake process, and initial or sign it. Consider posting your policy on your website and having a printed version available at your reception desk. Your business policies on your website should be in a conspicuous place and easy to find, especially from the booking page.

If you offer booking by phone, be sure to mention your no-show and cancellation guidelines, and that they can find your full policy on your website. You could say something like:

“…If you need to cancel your appointment, please be sure to do so before 24 hours prior to your appointment, to avoid the $25 no-show & late-cancellation fee.”

Review and update your policy once per year (or more frequently if needed). Make sure to inform your long-term clients if you make any policy changes. Take a few minutes at the end of each month to reflect on how your policies are working for your business, or if any changes would be better. You may need to make some adjustments as your practice grows.

How you enforce your policies depends on what’s best for your practice. It’s easiest to create a policy that you are comfortable with and then enforce it consistently. *Clients always prefer someone who is “easy to work with”. Remember that a new client that misses their first appointment may eventually turn into one of your best clients. You never know!

FAQ about massage no-shows and missed appointments

Should I charge a client if they miss their appointment?

In most cases, yes. It is best to create a no-show policy that clearly explains your response to a client no-show. Most clients understand that missing an appointment costs you time that you could have spent working with another client. Many massage therapists charge a no-show fee but may choose to waive it for a client’s first no-show. It just depends on the individual situation and what’s best for your practice. It can be a balancing act to remain flexible and easy to work with, while also maintaining boundaries.

What if a client frequently no-shows or cancels at the last minute?

If you’re in business long enough, you will probably get a few of these “problem clients”. These clients will test the limits of your patience and flexibility. They may have different reasons for missing their appointments, but if keeping an appointment is important enough to someone, then they can usually find a way to keep it. The best way to handle these clients is to create a rock-solid No-Show Policy and stick to it. Make sure that all of your clients are familiar with this policy, especially any problem clients that you may have. You can also try strategy #10 listed above, which is to schedule any unreliable clients as your last appointment of the day.