About this template
Gathering detailed client history is vital before performing professional skincare treatments. This comprehensive skincare consultation form template helps estheticians, dermatologists, and medical spas collect essential background information safely and efficiently before a client's first appointment.
Designed specifically for beauty and wellness professionals, this form captures vital health history, current skincare regimens, active ingredients like retinoids, medical conditions, allergies, and lifestyle factors that could impact treatment safety. It also covers primary skin concerns and goals, ensuring your treatments are both safe and tailored to the individual.
Built on Google Forms using Doc2Form, this template streamlines your client onboarding workflow. Eliminate messy paper clipboards and disorganized emails by gathering structured, ready-to-review client profiles directly in your Google Drive before they step through your door.
Key features
- Collect detailed skin history and lifestyle factors before treatment
- Screen for contraindications like retinoids, allergies, and health conditions
- Understand client goals and current product routines for better recommendations
- Built-in policy agreements for cancellations and post-treatment care
- Easily customize questions to match your spa or clinic's specific services
Use cases
First-time facial and chemical peel consultations at a day spa
Medical aesthetic clinic intake for laser and microdermabrasion treat…
Medical aesthetic clinic intake for laser and microdermabrasion treatments
Independent esthetician client onboarding and skin assessments
Virtual skincare coaching and product recommendation intake
What this form collects
- Consultation Date (Date)Select today's date.
- Full Name (Short answer)Enter your first and last name.
- Date of Birth (Date)Please provide your birth date.
- Mobile Number (Short answer)Enter the best phone number to reach you regarding appointment updates.
- Email Address (Short answer)Where should we send your appointment confirmation and aftercare notes?
- Preferred Appointment Date (Date)When would you like to schedule your visit?
- Skin Care Goals (Checkboxes)What are your primary skin concerns or goals for your treatments? Select all that apply.
- Skin Care Challenge Details (Paragraph)Please describe your current skin challenges in more detail.
- Current Skin Care Products (Paragraph)List the cleanser, moisturizer, sunscreen, and serums you currently use daily.
- Vitamin A Derivative Use (Multiple choice)Are you currently using Retin-A, retinol, tretinoin, or prescription acne topicals?
- Health Conditions History (Checkboxes)Do you have any active medical conditions, skin disorders, or chronic illnesses? Select all that apply.
- Allergy Status (Paragraph)Do you have any known allergies to nuts, latex, fragrances, aspirin, or specific skincare ingredients?
- Pregnancy or Breastfeeding Status (Multiple choice)Are you currently pregnant, trying to conceive, or breastfeeding?
- Stress Level Rating (Linear scale)Rate your average daily stress level on a scale from 1 (Low) to 5 (High).
- Terms and Conditions Acceptance (Multiple choice)I confirm that the information provided above is accurate to the best of my knowledge, and I agree to salon policies regarding cancellations and post-treatment care.
- Signature (Short answer)Please type your full legal name as your electronic signature.
FAQ
How do I share this consultation form with my clients?
Once your Google Form is generated through Doc2Form, you can share the link via email, text message, embed it on your booking website, or set it up in your automated confirmation emails.
Can I edit the questions on this skincare intake form?
Yes! Because the form lives directly in your Google Drive, you have full freedom to add, remove, or modify any questions to fit your specific spa services or treatment menu.
Is this form mobile-friendly for my clients?
Google Forms are fully responsive by default, meaning your clients can easily fill out their consultation details on their smartphones or tablets right before their appointment.
Where do the submitted consultation details go?
All responses are automatically organized in a connected Google Sheets spreadsheet, giving you an instantly searchable client database.
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.