This Esthetician Client Intake Form is a document that asks all the questions your new clients need to answer to give you a good understanding of their medical and skincare history and any considerations you need to consider for their cosmetic or skin treatment.

This form is used to collect information about new clients and used for internal purposes only. The information you provide is confidential and will be treated accordingly.

Esthetician Client Intake Form Zip Code No First Name Address Email Full Name Full Name Last Name Client Information Date of Birth City Preferred Phone Number Gender ... Skin Care History Do you use or have you used in the last 3 months Retin-A, Renova, AHA's, or Retinol/Vitamin A derivative products? If yes, please describe: ...

This Esthetician Client Intake Form contains form fields that ask about the client's personal details like name, contact details, address, and occupation. It also asks if the client has any medical conditions that might be affected during or after the cosmetic or skin treatment.

An Esthetician Client Intake Form is a crucial document used by skincare professionals to gather detailed information about a client's health history, skincare habits, and preferences, ensuring they receive treatments best suited to their individual needs.

The purpose of the Confidential Client Intake Form is to gather crucial information about clients seeking esthetician services. By collecting data on skin care concerns, medical history, and personal details, the esthetician can offer tailored treatments to meet individual needs.

Do you have any of the following conditions? If yes, please select them: How does your skin heal? How do you take care of your skin at home? How do you take care of your skin at work? Do you consume alcohol? Are you pregnant? Are you trying or planning to be pregnant? Are you taking any contraceptive pills? Are you breastfeeding?

Have you been under the care of a dermatologist or other physician within the past year? Do you use or have you used in the last 3 months: Retin-A, Renova, AHA’s, or Retinol/Vitamin A derivative products? Have you had chemical peels, microdermabrasion, or resurfacing treatments in the past month?

Attract new clients with this smooth, inviting intake form. No need to spend hours on phone calls or emails—this form helps estheticians capture client data in one go. Get started by customizing this free template.