About this template
Preparing for a professional skin waxing service requires a thorough understanding of a client's medical history, current skincare regimen, and potential contraindications. This Wax Client Intake Google Form Template helps estheticians, salon owners, and beauty professionals collect vital health and skin background information safely and efficiently before an appointment.
The form systematically gathers essential contact details alongside critical pre-treatment disclosures, such as recent use of chemical exfoliants (AHA/BHA), prescription retinoids, Accutane, skin-thinning medications, sun exposure, and relevant medical conditions like diabetes or recent cancer treatments. By screening for these factors ahead of time, practitioners protect their clients from adverse skin reactions and ensure optimal waxing results.
Built for seamless digital use via Doc2Form, this template removes the hassle of clipboards and paper clutter. Clients can complete the questionnaire smoothly on their phones before arriving at the salon, allowing you to review notes in advance, secure digital consent, and maintain clean, organized client records.
Key features
- Screen for contraindications like Retin-A, Accutane, and AHAs instantly
- Collect mandatory liability and treatment consent before the service
- Track relevant medical history, sun exposure, and current medications
- Fully mobile-optimized for clients to complete on their smartphones
- Automatically organize all client responses in a secure Google Sheet
Use cases
- Pre-appointment screening for new facial and body waxing clients
- Documenting skin sensitivity factors and topical medication use
- Collecting digital liability waivers for independent estheticians
- Streamlining salon front-desk check-in procedures
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Email Address (Short answer)We will use this to send appointment confirmations and aftercare instructions.
- Phone Number (Short answer)Enter your best contact number for appointment updates.
- Home Address (Paragraph)Enter your street address, city, state, and zip code.
- Have you used AHAs, BHAs, or glycolic acid in the past 48 to 72 hours? (Multiple choice)Includes chemical peels, exfoliating toners, or resurfacing cleansers.
- Are you currently using Retin-A, Renova, Differin, or Accutane? (Multiple choice)Or any other prescription vitamin A topical treatments.
- Are you using any skin-thinning or acne-drying products? (Multiple choice)Includes benzoyl peroxide, salicylic acid spot treatments, or prescription topicals.
- Do you use tanning beds or receive regular artificial sun exposure? (Multiple choice)Select yes if you have tanned within the last 14 days.
- Do you have regular daily sun exposure? (Multiple choice)Includes outdoor work, sports, or long commutes.
- Do you have diabetes or circulatory conditions? (Multiple choice)These conditions can impact healing and skin sensitivity.
- Do you have a history of cancer or ongoing cancer treatments? (Multiple choice)Please let us know if you are currently undergoing chemotherapy or radiation.
- List any current medications or skin care products you use regularly (Paragraph)Include prescription drugs, over-the-counter topicals, and anti-aging serums.
- List any other current illnesses or skin conditions (Paragraph)E.g., eczema, psoriasis, herpes outbreaks, or recent scarring in the treatment area.
- When is your next menstrual cycle expected? (Date)Optional: skin can be extra sensitive during hormonal fluctuations.
- Client Signature (Short answer)By typing your full legal name below, you confirm that the information provided is accurate and you consent to the waxing service.
- Date of Signature (Date)Today's date.
FAQ
How do I share this intake form with my clients?
Once your template is generated as a Google Form, simply copy the shareable link and send it via email, text message, or include it in your automated booking confirmation emails.
Can I customize the skincare and medication questions?
Yes! Because the form lives in your Google Drive, you can easily add, remove, or edit any questions to match your salon's specific pre-treatment protocols.
Why is it important to ask about Retin-A and Accutane use?
Certain topical medications and oral treatments thin the skin and increase skin sensitivity, making waxing treatments unsafe without proper precautions or waiting periods.
Where are client responses stored?
All client submissions are automatically routed to your Google Drive and linked Google Sheet, ensuring your client health records remain secure and accessible.
Can clients sign this form on their mobile phones?
Absolutely. Google Forms are fully responsive and designed to work seamlessly on mobile devices, tablets, and desktop computers.
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.