Esthetician Intake Form Template

Facial appointments go smoother when the chart already knows the skin story. This esthetician intake form template collects concerns, allergies, products, and goals before the client arrives.

Great for

• Spas and med spas onboarding new facial clients
• Independent estheticians sending a pre-visit link
• Salons that want the same intake on every first appointment

Focus on what changes the service: concerns, allergies, actives, recent treatments, and pregnancy status. Leave full medical charts for your clinic system if you already have one.

Send the form with the booking confirmation so answers are ready before the facial. Export CSV when you need a simple archive outside the booking tool.

Questions in this template

1. Client name *
   Name
2. Email *
   Email
3. Phone *
   Phone
4. Main skin concerns *
   Checkboxes Acne, Dryness, Sensitivity, Aging or fine lines, Pigmentation, Other
5. Allergies *
   Long text
6. Current medications or topicals *
   Long text
7. Recent treatments *
   Long text
8. Are you pregnant or nursing? *
   Yes or no
9. Treatment goals *
   Long text
10. Signature confirming this information is accurate *
    Signature