About this template
Streamline your client onboarding and deliver personalized treatments with this comprehensive Skincare Appointment and Client Intake Google Form Template. Designed specifically for estheticians, dermatologists, and medical spa professionals, this form captures vital client background information before their appointment.
Collect essential contact details alongside detailed health history, current skincare regimens, product usage, allergies, and specific skin goals. By gathering this data upfront, practitioners can screen for contraindications such as vitamin A derivatives, recent chemical peels, or medical implants, ensuring safe and effective treatments every time.
Built for seamless digital intake, Doc2Form lets you generate this ready-to-use Google Form in seconds. Eliminate messy paper clipboards, reduce front-desk bottlenecks, and give your clients a smooth, professional introduction to your clinic.
Key features
- Capture complete skin history and personal skincare goals before appointments.
- Screen safely for allergies, medications, and recent cosmetic treatments.
- Organize contact details, birthdates, and referral sources in one spreadsheet.
- Accept policy agreements and digital signatures instantly.
- Fully customizable to match your clinic's specific treatment offerings.
Use cases
New client onboarding at medical spas and boutique skincare clinics.
Pre-treatment consultations for advanced facials, chemical peels, and…
Pre-treatment consultations for advanced facials, chemical peels, and laser sessions.
Virtual skin consultations where clients submit history prior to vide…
Virtual skin consultations where clients submit history prior to video calls.
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Email Address (Short answer)Where we can send your appointment confirmations and aftercare instructions.
- Phone Number (Short answer)Your best contact number for appointment reminders.
- Date of Birth (Date)Please enter your birth date.
- Preferred Appointment Date (Date)Select the date you would like to schedule your visit.
- Address (Paragraph)Street address, city, state, and zip code.
- How did you hear about us? (Dropdown)Select the main source that brought you to our clinic.
- Primary Skin Care Goals (Paragraph)What are the main results you want to achieve with your skin?
- Current Skin Challenges (Checkboxes)Select all skin concerns you are currently experiencing.
- Have you had professional facial treatments before? (Multiple choice)Choose your prior experience level.
- Current Skincare Product Types Used (Checkboxes)Select the products you currently use in your daily routine.
- Are you currently using any Vitamin A derivatives or prescription retinoids? (Multiple choice)E.g., Retin-A, Tretinoin, Differin, or high-strength retinol.
- Have you had waxing, hair removal, or laser treatments in the last 30 days? (Multiple choice)This helps us prevent skin irritation during your service.
- Recent Chemical Peel, Laser, or Microdermabrasion (Multiple choice)Have you received any advanced resurfacing treatments in the past 3 months?
- Recent Botox or Dermal Fillers (Multiple choice)Have you had injectables within the last 2 weeks?
- Known Allergies (Paragraph)List any allergies to foods, medications, latex, nuts, or specific cosmetic ingredients.
- Health Conditions & Medical History (Paragraph)List any relevant medical conditions, skin diseases, or recent surgeries.
- Are you pregnant or breastfeeding? (Multiple choice)Certain active ingredients must be avoided during pregnancy.
- Current Stress Level (Linear scale)Rate your overall daily stress level on a scale from low to high.
- Post-Care Instructions & Cancellation Policy Acceptance (Short answer)Type your full legal name to confirm you understand our cancellation policy and agree to follow post-treatment care instructions.
FAQ
How do I customize this skincare intake form?
Once generated in your Google Drive via Doc2Form, you can freely edit, add, or remove any questions using the standard Google Forms editor.
Can I collect client signatures with this form?
Yes, you can include text fields for typed legal acknowledgments, treatment disclaimers, and cancellation policy agreements.
Is this form mobile-friendly for my clients?
Absolutely. Google Forms automatically optimizes layout and functionality for smartphones, tablets, and desktop computers.
Where does the submitted client data go?
All client responses flow directly into a connected Google Sheets spreadsheet, making it easy to review client details before their appointment.
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.