TemplatesEsthetician
esthetician intake form
A multi-service intake form has a structural problem that a single-treatment form does not: the union of every screening question is far too long, and the intersection is far too short.
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- screening questions
- 8screening questions
- stop the appointment
- 4stop the appointment
- minutes to set up
- 10minutes to set up
- a month to start
- $8a month to start
Facial consent and skin intake
Full name
Date of birth
Email
Phone
Have you taken isotretinoin (Accutane) in the last 6 months?
YesNo
Isotretinoin
Why this form, specifically
It stops the two-year drift where the form stays the same and the menu does not, and it keeps marketing consent in its own box where a regulator expects it.
Look before you download
The whole document, before you give us anything
Facial consent and skin intake
Your details
Full name
Date of birth
This is where your aftercare instructions go.
Phone
Health questions
Have you taken isotretinoin (Accutane) in the last 6 months?
Skin stays fragile for months after the last dose.
Do you use retinol, tretinoin or another retinoid on this area?
Including prescription creams and strong over-the-counter serums.
Have you had Botox or fillers in this area in the last 2 weeks?
This is the form you get
Not a sample, not a preview of a preview. Every question below is in your account ten minutes after you sign up, with the flags already set and the aftercare email already written.
- 14-day trial
- No card needed
- Set up in 10 minutes
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The 8 answers that should stop you
A multi-service intake form has a structural problem that a single-treatment form does not: the union of every screening question is far too long, and the intersection is far too short. The answer is a shared core plus branches, which is easy digitally and genuinely hard on paper.
Do not treat
4WhyThinned epidermis and near-absent sebum production. Extraction and exfoliation both act on a skin that cannot take them.
What goes wrong if you treat anywayTearing during extractions, prolonged erythema, and scarring.
What to doNo exfoliation, no extractions, no peels for six months. A gentle hydrating facial is defensible; nothing more.
The question that catches itHave you taken isotretinoin (Accutane) in the last 6 months?
WhyMassage and heat can migrate product before it has settled, and injection sites are open channels for a fortnight.
What goes wrong if you treat anywayProduct migration, an asymmetric result the injector gets blamed for, and infection risk at the sites.
What to doTwo weeks after Botox, two weeks after filler. Ask for the date, not the season.
The question that catches itHave you had Botox or fillers in this area in the last 2 weeks?
WhyHerpes simplex spreads readily across facial skin under manipulation, steam and heat.
What goes wrong if you treat anywayA widespread outbreak and, with shared equipment, a cross-contamination problem.
What to doAn active lesion is an absolute no. A history means warn, and consider antiviral cover arranged with their doctor.
The question that catches itDo you get cold sores?
WhyThe barrier is still rebuilding, however normal the skin looks.
What goes wrong if you treat anywaySensitivity, hyperpigmentation, and an undone result.
What to doWait a fortnight, longer for medium-depth work.
The question that catches itHave you had a peel, laser or microdermabrasion on this area in the last 2 weeks?
Proceed with caution
4WhyHome actives have already thinned the stratum corneum. A professional exfoliant stacks on top of a skin that is already mid-turnover.
What goes wrong if you treat anywayOver-exfoliation, a compromised barrier, and weeks of sensitivity and flaking.
What to doAsk them to stop actives five days before. If they have not, do a hydrating facial instead and say why.
The question that catches itDo you use retinol, tretinoin or another retinoid on this area?
WhyHeat, steam and massage are vasodilators. Rosacea in particular is a vascular condition that heat provokes directly.
What goes wrong if you treat anywayA flare that outlasts any benefit from the treatment.
What to doNo steam and no heat on rosacea. Work around eczema. Infected or cystic acne gets referred, not extracted.
The question that catches itDo you have eczema, psoriasis, rosacea or active breakouts on this area?
WhyProfessional products are more concentrated than retail, and botanical extracts are among the commonest sensitisers.
What goes wrong if you treat anywayContact dermatitis on the face, which takes days to settle and is highly visible.
What to doTake the list before you choose the products, not after. Patch test anything new behind the ear.
The question that catches itDo you have any allergies we should know about?
WhySkin is more reactive and prone to melasma. Several standard actives, notably high-percentage salicylic acid and retinoids, are avoided in pregnancy.
What goes wrong if you treat anywayPigmentation that is slow to resolve, and use of an ingredient the client would rather have avoided.
What to doSwitch to a pregnancy-safe protocol: lactic or mandelic acid, no retinoids, no high-strength salicylic. Say so out loud.
The question that catches itAre you pregnant or breastfeeding?
What you actually get
Nobody buys a consent form
They buy the fifteen minutes back at the start of an appointment. They buy the phone call they did not have to make, because the contraindication turned up two days early instead of two minutes late. They buy an insurer who pays out, because the patch test has a timestamp rather than a memory attached to it.
The form is the mechanism. What you are actually buying is the record it leaves behind.
That is the whole argument, and it is why the questions matter more than the software. A blank form builder hands you a canvas and calls it flexibility. This hands you the nine questions that a waxing client should be asked, in the wording that gets an honest answer, with the risky one already flagged in red.
What this saves you
Not what the form contains - what it gives you back. Every number below is arithmetic you can check on the calculator further down the page.
Before they sit down
not halfway through
A form that collects answers and does nothing with them has solved the wrong problem. A risky answer turns the submission red and names the reason at the top, at the only moment the information is worth anything.
12 hours
a year, back in your chair
A new client filling in a paper form in your treatment room costs ten to fifteen minutes of an appointment they already paid for. Send it with the booking confirmation and that time goes back into treating, at roughly twelve hours a year on twenty clients a week.
A defensible claim
instead of a disputed memory
Most professional policies in these trades condition cover on documented screening, and a patch test you can describe is not a patch test you can produce. A timestamped record is the difference between a claim your insurer defends and one they decline.
4 seconds
from signature to aftercare email
The aftercare for their treatment lands in their inbox before they have left the chair, written for that service and editable in your words. Clients who follow aftercare heal better, complain less and rebook more - and you did nothing.
Same week. One thing changed.
The left-hand column is most studios today. The right-hand one is the same week with the form sent at booking instead of handed over on arrival.
- She arrives, you hand her a clipboard, she fills it in while you wait
- Halfway through she mentions the retinol she uses nightly
- You improvise a gentler treatment and hope
- The form goes in a folder you will never open again
Nothing here is negligent. It is just undocumented.
- The form was done at home, the evening she booked
- You saw the retinol answer flagged in red two days ago
- You rescheduled by message, before either of you lost the slot
- It is on her record, searchable, next time she books
Same treatments, same clients, same you. Different record.
Try the flag
Answer these as if you were the client
Answer honestly and nothing happens. Answer yes to the one that matters and watch what lands on your side.
What the client sees
Have you taken isotretinoin (Accutane) in the last 6 months?
Have you had Botox or fillers in this area in the last 2 weeks?
Do you use retinol, tretinoin or another retinoid on this area?
Do you have eczema, psoriasis, rosacea or active breakouts on this area?
What you see
Answer honestly and nothing happens. Answer yes to the one that matters and watch what lands on your side.
In your submissions list
Esthetician
What goes wrong without it
The failure is a filing problem rather than a clinical one.
An esthetician runs six services, keeps intake forms in a ring binder by first name, and after two years has around 400 of them. A former client's solicitor writes asking for a copy of her records, giving a surname the esthetician never recorded and a date range spanning eleven months. Finding it takes an evening. Proving that nothing was added afterwards is impossible, because it is a paper form in a binder that anybody could have written on. The record existed and could not do the one job it was kept for.
What a esthetics treatments intake form has to cover
The actual field list, and why each group is on this particular form.
Contact and service
- Full name
- Date of birth
- Phone
- Which services you are booked for
- How did you hear about us
The service field routes everything after it. On paper that means a long form with sections crossed out; done properly it means the client only ever sees the questions their appointment needs.
Skin and body history
- Skin type and concerns
- Home routine and actives
- Previous professional treatments and reactions
- Sun exposure habits
- Hair removal history if relevant
An esthetician's intake has to cover both face and body, which is what separates it from a facial-only form and why the generic versions feel wrong to use.
Medical
- Medication including isotretinoin
- Allergies including fragrance and latex
- Skin conditions
- Diabetes and healing conditions
- Pregnancy or breastfeeding
- Recent injectables or resurfacing
Latex belongs on an esthetician's list and not on a facial-only one, because gloves and some waxing products contain it.
Consent and communication
- Consent statement and initials
- Photo and social media permission
- Aftercare email consent
- Marketing consent, as a separate box
- Signature with timestamp
Marketing consent has to be a separate, unticked box. Bundling it into treatment consent is the mistake that turns a form into a compliance problem.
Is a digital signature legally valid?
Exact time signed
IP address
Device and browser
The exact form they saw
Yes - the US ESIGN Act and the state UETA adoptions give it the same legal effect as ink. What makes it hold up is the evidence stored beside it, and a paper form in a drawer carries none of this.
Sign with your fingerDraw a signature with your mouse or trackpad
Where you stand legally
Two things make an esthetician's intake form different from a single-treatment one, and both are about data. First, you are collecting a broader medical picture than any one appointment needs, which raises the question of why you hold it. The defensible answer is that it informs treatment selection across your menu - but that only holds if you actually use it, and if you do not collect fields you never look at. Second, consent to be treated is not consent to be marketed to. The two have to be separate boxes, the marketing one unticked by default, and the distinction has to survive into whatever you export the data into. State privacy laws increasingly reach small businesses, and the specific pattern regulators pursue is bundled consent. Retention is the third question: keep treatment records for as long as a claim could be brought, and delete marketing data when someone asks. General guidance, not legal advice.
Paper, PDF or digital?
Paper
Fine when you are small
- Signed before they arrive
- Flags contraindications
- Findable by name in seconds
- Proves when it was signed
- Sends aftercare automatically
- Costs nothing
Emailed PDF
Worst of both
- Signed before they arrive
- Flags contraindications
- Findable by name in seconds
- Proves when it was signed
- Sends aftercare automatically
- Costs nothing
Digital
Earns its place at scale
- Signed before they arrive
- Flags contraindications
- Findable by name in seconds
- Proves when it was signed
- Sends aftercare automatically
- Costs nothing
Three clients a week? Print it and staple it in a binder. That is genuinely fine, and software would be an expense with no return. Digital earns its place around ten to fifteen clients a week, when finding one form again matters more than the minutes it took to file it.
Questions people actually ask
A service selector, contact details with date of birth, skin and body history, home routine and actives, medical screening, and separate consent boxes for treatment, photos and marketing. The service selector is what stops it becoming a twelve-page document.
Your form is written. Come and get it.
Pick your service, and it is in your account before you have finished making a coffee. 14 days free, no card.
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General guidance for professionals, not legal or medical advice. Check the rules that apply where you work.