About this template
An Aromatherapy Client Consultation Form is an essential document completed prior to any therapeutic session. It gathers vital health background, lifestyle information, and specific wellness goals to ensure treatments are both safe and tailored to the individual. By collecting comprehensive health details upfront, practitioners can identify contraindications, tailor essential oil blends, and deliver a personalized, high-quality care experience.
This template captures contact information, emergency contacts, detailed medical history, current medications, lifestyle habits, and targeted wellness goals such as stress relief or pain management. It also includes sections for appointment scheduling and liability acknowledgments. Utilizing Doc2Form, wellness practitioners can instantly convert and deploy this consultation template into Google Forms, streamlining their client onboarding workflow and maintaining organized digital records for every session.
Key features
- Comprehensive health history and medical background tracking
- Integrated lifestyle, stress level, and wellness goal questions
- Appointment scheduling and preferred session timing
- Built-in liability acknowledgment and client consent
- Instant conversion to Google Forms for easy digital sharing
Use cases
- New client onboarding at day spas and wellness clinics
- Pre-treatment health screenings for massage and aromatherapy sessions
- Holistic health practice client intake management
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Date of Birth (Date)Format: MM/DD/YYYY
- Gender (Multiple choice)Select the option that best describes your gender.
- Telephone Number (Short answer)Enter the best phone number to reach you regarding your appointment.
- Home Address (Paragraph)Enter your current residential address.
- Employment Status (Dropdown)Select your current employment situation.
- Primary Reason for Visit (Paragraph)What are your main goals for today's aromatherapy session?
- Health & Medical History (Checkboxes)Please review the following health conditions. Check any that currently apply or have applied in the past.
- Pregnancy Status (Multiple choice)Are you currently pregnant or trying to conceive? (Certain essential oils are restricted during pregnancy).
- Allergy Details (Paragraph)Please list any known allergies to nuts, plants, fragrances, or topical products.
- Current Medications (Paragraph)List any prescription medications or supplements you are currently taking.
- Current Stress Level (Linear scale)Rate your overall stress level on a scale from 1 (Very Low) to 5 (Extremely High).
- Preferred Oils & Scents (Paragraph)Do you have any preferred essential oils, or specific scents you dislike?
- Terms and Conditions (Multiple choice)Please confirm that the information provided is accurate and that you understand aromatherapy is a complementary wellness practice, not a medical treatment.
- Client Signature (Short answer)Please type your full legal name as an electronic signature.
- Date Signed (Date)Select today's date.
FAQ
How do I share this template with my clients?
Once you convert this template using Doc2Form, you can share the Google Form link via email, embed it on your website, or send it in an appointment confirmation text.
Can I customize the health and lifestyle questions?
Yes! Since the template lives right in your Google Drive, you can easily add, remove, or edit any questions to fit your specific practice requirements.
Is this form suitable for mobile devices?
Yes, Google Forms are fully responsive and look great on smartphones, tablets, and desktop computers, making it easy for clients to fill out before arriving.
How does Doc2Form help me set this up?
Doc2Form instantly transforms this structured template into a ready-to-use Google Form in your account, saving you hours of manual form building.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.