Esthetics Client & Health Intake

Edit a esthetics client & health intake template for estheticians. Review it online, then unlock licensed PDF, Word, and print tools after purchase.

For Estheticians · Intake Form · CA$5

Record client goals, relevant skin, hair, nail, or body history, allergies, sensitivities, medications disclosed by the client, prior services, and the requested facial, skin-care, hair-removal, or authorized esthetic service.

Included editable fields

  • Esthetician
  • Client / Customer / Authorized Party
  • Client Name
  • Appointment Date / Time
  • Skin Concern / Goal
  • Skin Type / Condition
  • Allergies / Medications Disclosed
  • Products / Contraindications
  • Intake Date
  • Service / Job Location
  • Job / Service Type
  • Scope / Purpose
  • Client Instructions / Prior History
  • Client Responsibilities
  • Pre-Start Confirmations
  • Known Risks & Disclosures
  • Limitations & Exclusions
  • Information Authorization / Acknowledgement
  • Intake Checklist
  • Follow-Up / Outcome
  • Record Timestamp
  • Service Provider / Professional