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facial intake form

An intake form's job is different from a consent form's.

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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 surfaces the tretinoin she wrote on line eleven at the moment it matters, instead of leaving it in a folder while you work from memory.

Look before you download

The whole document, before you give us anything

Facial consent and skin intake

Your details

Full name

Date of birth

Email

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?

Page 1 of 3

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.

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  • No card needed
  • Set up in 10 minutes
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4 stop treatment4 need cautionDo not treat, Proceed with caution, Safe to proceed

The 8 answers that should stop you

An intake form's job is different from a consent form's. Consent records a decision; intake gathers the information that makes the decision safe. The medical section is the same as the consent form's - what changes is the depth of the routine and history sections in front of it.

Do not treat

4
  • WhyThinned 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

4
  • WhyHome 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.

On paper
  1. She arrives, you hand her a clipboard, she fills it in while you wait
  2. Halfway through she mentions the retinol she uses nightly
  3. You improvise a gentler treatment and hope
  4. The form goes in a folder you will never open again

Nothing here is negligent. It is just undocumented.

With Lumela
  1. The form was done at home, the evening she booked
  2. You saw the retinol answer flagged in red two days ago
  3. You rescheduled by message, before either of you lost the slot
  4. 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

Facials0

Facial

What goes wrong without it

The failure here is quieter than a burn.

A studio collects beautiful intake forms - three pages, full routine, goals, lifestyle - and never reads them again. The information sits in a folder while the esthetician relies on memory and on what the client mentions on the day. Nine months later, the client who wrote 'tretinoin 0.05%' on line eleven of her intake has a reaction to an enzyme peel. The form contained the answer. Nobody surfaced it at the moment it mattered, which is the specific problem a paper intake form cannot solve and a digital one can.

What a facials intake form has to cover

The actual field list, and why each group is on this particular form.

Contact and referral

  • Full name
  • Date of birth
  • Email
  • Phone
  • How did you hear about us

The referral field is the one non-clinical question worth keeping. It is the only marketing attribution a small studio ever gets, and it costs one line.

Skin profile

  • Skin type
  • Primary concern
  • Secondary concerns
  • How your skin behaves in summer and winter
  • Sensitivity and reactions
  • Sun exposure and SPF habits

Asking how skin behaves across seasons gets more useful answers than asking someone to self-classify as 'combination', which almost everybody says.

Current routine

  • Morning products
  • Evening products
  • Actives: retinoids, acids, vitamin C
  • Prescription treatments
  • Supplements
  • How long on the current routine

This section is the difference between an intake form and a contact form. It is also where the contraindication that matters usually surfaces.

Medical and lifestyle

  • Isotretinoin history
  • Recent injectables
  • Cold sores
  • Allergies
  • Medication
  • Pregnancy or breastfeeding
  • Smoking, water intake, sleep

The lifestyle questions are not filler. They set realistic expectations, and a client who has said out loud that she sleeps five hours is a client who will accept that one facial is not a transformation.

Goals and consent

  • What would you like to change
  • Budget and frequency expectation
  • Consent statement and signature
  • Photo permission

Asking about frequency before the treatment rather than after it is what turns a single facial into a course, without a sales conversation.

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 finger

Where you stand legally

An intake form is not a consent form and does not substitute for one. It is common, and defensible, to combine them into a single signed document, but the signature has to attach to a consent statement rather than only to a list of answers. Where studios get this wrong is by collecting a rich intake form with no consent wording and no signature block, then treating it as the record. If a complaint arrives, that document proves you gathered information and proves nothing about what the client agreed to. Keep both functions, on one page if you like, and make sure the signature sits under language that says the client understood the treatment, its risks and its normal effects. Retention follows the same rule as any client record: several years, and longer if your state board says so. 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

  • Intake gathers information; consent records a decision. Most studios combine them, which is fine, provided the signature sits under actual consent wording rather than under a list of answers.

Your form is written. Come and get it.

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General guidance for professionals, not legal or medical advice. Check the rules that apply where you work.

Facial Intake form: Ready-Made, Signed On Their Phone . Lumela