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Esthetician Client Intake Form Template

Streamline Your Client Consultation Process with Ease

Collecting essential client information doesn't have to be a hassle. This esthetician client intake form template helps you gather medical histories, identify allergies, and understand skincare concerns in one convenient tool. Streamline your client's onboarding process, ensure you provide personalized treatment, and enhance communication-all while maintaining compliance with best practices. With WCAG-aligned labels, you can also ensure accessibility for all clients. Start using this live template to simplify your workflow today.

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Full name
Email address
Mobile phone number
Date of birth
Preferred contact method
Phone call
Text message
Email
Emergency contact full name
Emergency contact phone
Relationship to you
Spouse/Partner
Parent/Guardian
Sibling
Relative
Friend
Caregiver
Other
Please Specify:
Do you have or have you ever had any of the following conditions?
Please Specify:
Allergies or sensitivities (select all that apply)
Please Specify:
If you selected Other for allergies, please list them
Are you pregnant, trying to conceive, or breastfeeding?
Pregnant
Trying to conceive
Breastfeeding
None of the above
Prefer not to say
Are you currently taking or using any of the following?
Please Specify:
When did you last use exfoliating acids (AHA/BHA) or retinoids on areas to be treated?
Within the last 24 hours
2-3 days ago
4-7 days ago
8-14 days ago
More than 2 weeks ago
Never or not sure
How would you describe your skin?
Very dry
Dry
Combination
Oily
Very oily
Balanced/Normal
Not sure
Which skin concerns are you currently experiencing?
Please Specify:
What skincare products are you currently using regularly?
How often do you apply SPF 30+ on your face and neck?
Never
Rarely
Sometimes
Often
Always
How sensitive is your skin to products or treatments?
Very sensitive
Somewhat sensitive
Not sensitive
Unsure
Fitzpatrick skin type (natural response to sun exposure)
I Always burns, never tans
II Usually burns, tans minimally
III Sometimes mild burn, tans uniformly
IV Rarely burns, tans easily
V Very rarely burns, tans very easily
VI Never burns, deeply pigmented
Which professional treatments have you had in the last 2 weeks?
Have you ever had an adverse reaction to skincare products or treatments?
Yes
No
If applicable, please describe any past reactions and the products or treatments involved
What services are you interested in today?
Please Specify:
Are you open to a patch test before treatment if recommended?
Yes
No
I confirm that the information provided in this form is accurate and complete to the best of my knowledge
Yes
No
I understand that certain medications and conditions may be contraindications and I have disclosed relevant information
Yes
No
I consent to receive esthetic services and understand potential risks such as temporary redness, irritation, or discomfort
Yes
No
I agree to follow the pre-care and post-care instructions provided by my esthetician
Yes
No
Photo consent preference
Yes, photos may be used for marketing
Yes, photos for my confidential record only
No photos
Communication preferences
Appointment reminders only
Reminders and promotions
Do not send marketing communications
I acknowledge the cancellation and no-show policy
Yes
No
Client signature (type full name)
Signature date
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Paper art illustration depicting an esthetician client intake form template for FormCreatorAI article.

When to use this form

Use this form before any new skin service or when a client's health changes. It captures skin concerns, allergies, medications, and recent treatments so you can plan safely. It is useful for first facials, corrective peels, sensitive skin cases, and pre- or post-laser care. Mobile techs can send it ahead so clients arrive ready. If you also perform hair removal the same day, pair it with the Waxing consultation form. For lash services in your studio, follow up with the Eyelash extension appointment form to cover adhesives and aftercare.

Must Ask Esthetician Client Intake Questions

  1. What are your top skin concerns and goals?

    This tells you what results matter most, from acne control to hyperpigmentation or anti-aging. You can set priorities, choose modalities, and measure progress in a way the client understands.

  2. Do you have any allergies, sensitivities, or past reactions to skincare, cosmetics, or adhesives?

    Knowing triggers helps you avoid ingredients and techniques that could irritate or harm the client. It also guides patch testing and product selection for safe, comfortable treatments.

  3. Which medications, supplements, or topicals are you using (e.g., Accutane/isotretinoin, Retin-A/tretinoin, AHAs/BHAs)?

    Some actives thin the skin or increase photosensitivity, raising the risk of burns or over-exfoliation. This lets you adjust strength, skip contraindicated services, or reschedule if needed.

  4. When was your last sun exposure, tanning, or professional treatment (peel, microdermabrasion, laser)?

    Recent exposure or procedures change how skin tolerates peels, extractions, and waxing. Timing services around these factors reduces complications and improves results.

  5. Are you pregnant, nursing, or managing any medical conditions we should consider?

    Health status affects ingredient choices (like salicylic acid or retinoids) and treatment intensity. If you are also booking hair services, we keep those details organized with the Hair salon client intake form.

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