About this template
Streamline your client onboarding process with this comprehensive Client Intake and Consent Form. Designed specifically for licensed estheticians, spa owners, and skin care professionals, this template helps you gather essential personal details, medical history, and treatment history before performing advanced skin treatments or procedures.
Collecting detailed background information—such as current medications, allergies, vitamin A use, and recent cosmetic procedures—is vital for ensuring client safety and delivering personalized treatments. With Doc2Form, you can instantly turn this document into a ready-to-use Google Form, allowing clients to fill out their intake paperwork digitally from their phone or computer before arriving at your salon.
By moving away from paper clipboards, you eliminate manual data entry, keep client records organized in your Google Drive, and ensure you have signed consent documented securely for every appointment. Customize the questions to match your specific treatment menu and branding in just a few clicks.
Key features
- Collect complete client contact and emergency details in one step.
- Screen for skin sensitivities, allergies, and active medications safely.
- Document history of recent laser treatments, chemical peels, and injectables.
- Eliminate paper clipboards with a mobile-friendly digital format.
- Instantly save and organize all client responses directly in Google Drive.
Use cases
First-time client consultations at a skincare clinic or day spa.
Pre-treatment screening for chemical peels, microdermabrasion, and la…
Pre-treatment screening for chemical peels, microdermabrasion, and laser procedures.
Updating annual medical history and consent files for regular salon c…
Updating annual medical history and consent files for regular salon clients.
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Date of Birth (Date)Please provide your birth date.
- Phone Number (Short answer)Best number to reach you regarding appointment updates.
- Residential Address (Paragraph)Street address, city, state, and ZIP code.
- Emergency Contact Name (Short answer)Name of someone we can reach in case of an emergency.
- Emergency Contact Phone Number (Short answer)Phone number for your emergency contact.
- Pregnancy or Breastfeeding Status (Multiple choice)Certain active ingredients are not recommended during pregnancy.
- Prescribed Medications (Paragraph)List any oral or topical prescription medications you currently take.
- Allergies and Skin Sensitivities (Paragraph)List any known allergies to ingredients, latex, fragrances, or adhesives.
- Vitamin A Derivatives Use (Multiple choice)Do you currently use prescription retinoids (e.g., Retin-A, tretinoin) or OTC retinol products?
- Vitamin A Use Recency and Frequency (Paragraph)If yes, how often do you apply it and when was your last application?
- Botox or Dermal Fillers (Multiple choice)Have you received botulinum toxin or dermal fillers in the treatment area recently?
- Chemical Peel or Laser Treatment History (Multiple choice)Have you had a professional chemical peel, microdermabrasion, or laser treatment in the last 4 weeks?
- Major Surgery in Past 90 Days (Paragraph)If you have undergone any major surgeries recently, please provide details.
- Authorization Date (Date)Select today's date to confirm authorization.
- Electronic Signature (Short answer)Type your full legal name to confirm that all information provided is accurate and that you consent to treatment.
FAQ
How do I send this intake form to my clients?
Once Doc2Form converts your template into a Google Form, you can easily share the link via email or text message, or embed it directly on your salon's website.
Can I edit the questions to match my specific spa services?
Yes! Because the template lives in your Google Forms account, you can add, remove, or modify any questions to fit your exact treatment menu.
Where are my clients' form submissions stored?
All responses are automatically collected in a linked Google Sheet stored securely in your Google Drive account.
Is this form mobile-friendly for clients filling it out on their phones?
Yes, Google Forms automatically optimizes layouts for smartphones, tablets, and desktop computers so clients can complete their paperwork on the go.
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.