About this template
A Facial Treatment Client Intake Form is essential for spas, estheticians, and skincare clinics to gather comprehensive health and skin history before administering treatments. Collecting this information upfront ensures safety by identifying potential allergies, sensitivities, medication conflicts, and contraindications such as recent resurfacing treatments or active skin conditions. This digital intake form covers everything from lifestyle factors and daily skincare regimens to specific skin concerns and medical history, allowing professionals to tailor their services safely and effectively.
Doc2Form makes it effortless to transform your client consultation process into an instant Google Form. By digitizing your intake paperwork, you eliminate clipboards and manual data entry while providing a smooth, mobile-friendly experience for your clients before they arrive at the spa. All responses are securely organized in your Google Drive, helping your team review client details in seconds, maintain accurate records, and deliver a truly customized skincare experience every single time.
Key features
- Collect complete health and skin histories prior to appointments.
- Identify allergies, current medications, and contraindications instantly.
- Mobile-friendly format for clients to complete on their phones or tablets.
- Directly integrates responses into Google Sheets for quick record keeping.
Use cases
- New client onboarding at day spas and medical aesthetic clinics.
- Pre-treatment skin consultation for advanced facial procedures.
- Tracking client skincare product usage and daily habits.
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Date of Birth (Date)Enter your date of birth (MM/DD/YYYY).
- Phone Number (Short answer)Enter the best phone number to reach you regarding appointments.
- Email Address (Short answer)Enter your primary email for booking confirmations.
- Emergency Contact (Short answer)Please provide a name and phone number for an emergency contact.
- Under Physician Care (Multiple choice)Have you been under the care of a physician in the past year?
- Physician Care Details (Paragraph)If yes, please describe the condition and treatment.
- Allergies (Paragraph)Do you have any known allergies to products, foods, or medications (e.g., nuts, aspirin, latex)?
- Current Medications and Supplements (Paragraph)List any prescription medications, OTC drugs, or supplements you are currently taking.
- Pregnancy Status (Multiple choice)Are you currently pregnant or breastfeeding?
- Primary Skin Concerns (Checkboxes)Select all skin challenges you would like to address.
- Current Skincare Products (Paragraph)List the facial cleanser, moisturizer, and active serums you currently use at home.
- Prescription Skincare Use (Multiple choice)Are you currently using prescription topical products (e.g., Retin-A, Accutane, Differin)?
- Daily Sunscreen Use (Multiple choice)Do you apply SPF daily?
- Current Stress Level (Linear scale)Rate your current daily stress level on a scale from 1 (Low) to 5 (High).
- Client Confirmation & Signature (Short answer)By typing your full legal name below, you confirm that the information provided is accurate and grant permission for the aesthetician to perform the facial treatment.
FAQ
What is the main purpose of a facial treatment client intake form?
It helps estheticians and spa professionals gather crucial health history, skin types, allergies, and lifestyle habits to safely and effectively customize facial treatments for each client.
Can I customize the questions in this Google Form template?
Yes! Once you generate the form in Google Forms, you can fully edit, add, or remove any questions to fit your specific spa menu and policies.
Is this form mobile-friendly for my clients?
Yes, Google Forms automatically optimize all forms for mobile devices, allowing clients to complete their intake paperwork easily from their smartphones or tablets before arriving.
Where are my client submissions stored?
All submissions are saved securely in your Google Drive account, and you can instantly link responses to a Google Sheet for easy organization.
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.