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Esthetician client intake form

The whole history, once, before the first appointment — so the first hour is treatment rather than paperwork.

Free, and no account needed to start. Send the link however you normally would: text, email, or a group chat. People fill it in on their phones. Sort the answers, search them, download them as a spreadsheet. 100 replies a month on the free plan.

Or download the printable PDF. Free, no email address, ready to print and pin up.

Already have your own version? Upload it and keep your wording.

The form people fill in, and the list you get back

This is the real form, not a screenshot of one, and it works. Below it is what you see as the answers come in.

New client skin intake

22 questions · takes about 6 min

How did you hear about us?
Have you seen an esthetician before?
Main concerns

Select all that apply.

How would you describe your skin?
Are you using any of these?

Select all that apply.

Do any of these apply to you?

Select all that apply.

Treatments you have had before

Select all that apply.

Sun exposure and protection
May we email you about appointments and offers?
Signature
Sign above with your finger or mouse

By signing here I agree that this signature, and the answers submitted with it, are mine and have the same effect as a signature on paper.

All 22 questions

  1. Full name (required)
  2. Pronouns
  3. Date of birth (required)
  4. Phone number (required)
  5. Email address (required)
  6. How did you hear about us?
  7. Have you seen an esthetician before? (required)
  8. What would you like to achieve? (required)
  9. Main concerns (required)
  10. How would you describe your skin? (required)
  11. Your current routine (required)
  12. Are you using any of these?
  13. Do any of these apply to you? (required)
  14. Medications and supplements
  15. Allergies and sensitivities
  16. Treatments you have had before
  17. Sun exposure and protection (required)
  18. Anything else about your lifestyle we should know?
  19. May we email you about appointments and offers? (required)
  20. I confirm the information above is accurate and I will tell my esthetician if anything changes (required)
  21. Signature (required)
  22. Date (required)

You can reword any of these, or add your own, after you create it.

An example of what you see when answers come in, with three replies
04 Aug, 17:53Yuki Tanakashe/her1984-01-16(619) 555-0178yuki.t@example.comSearchYes, regularlyMelasma across my cheeks that comes back every summer. Want a plan rather than one-off treatments.Pigmentation or melasma, Fine linesNormalAM: cleanser, azelaic acid, mineral SPF 50. PM: cleanser, tretinoin 0.025%, ceramide cream.Retinol or tretinoin, Azelaic acidThyroid conditionLevothyroxineShellfishFacials, Chemical peels, Laser or IPLI wear SPF dailyTwo young children, very little sleepReminders and offersYes2026-08-04
04 Aug, 08:26Devon Achebethey/them1999-10-21(858) 555-0107d.achebe@example.comAnother client referred meNo, this is my first timeBeen on acne meds for a year and my skin is dry and marked. Want help repairing it.Acne scarring, Dryness, Pigmentation or melasmaDryAM: water only, moisturiser. PM: cleanser, adapalene, moisturiser.Prescription topicalIsotretinoin (Accutane) now or in the last six monthsIsotretinoin 30mg, finished last monthNone knownNone of theseI rarely wear SPFAppointment reminders onlyYes2026-08-04
03 Aug, 20:11Camille Bouchershe/her1992-06-04(619) 555-0133camille.b@example.comInstagram or TikTokYes, but not recentlyWedding in October. I want to stop wearing foundation every day.Blackheads and congestion, TextureCombinationAM: gentle cleanser, vitamin C, SPF 30. PM: cleanser, moisturiser. Retinol twice a week when I remember.Retinol or tretinoin, Vitamin CNone of theseCombined pillNone knownFacials, WaxingI wear SPF sometimesSleeping badly since MarchReminders and offersYes2026-08-03

Scroll sideways for the rest of the 22 answers, and press any heading to sort by it. In your own form you can search the answers as well, and download them as a spreadsheet at any time.

This is the form that decides the first appointment

An intake form is not a consent form. Consent records that a client agreed to a specific treatment; intake is the history the esthetician uses to decide which treatment to offer. They are usually collected together and they answer different questions.

The goal question in the client's own words is the one worth protecting from being cut. "What would you like to achieve" gets an answer a checklist cannot: somebody writes that they have a wedding in six weeks, or that they have stopped going out without makeup, and the whole plan follows from that.

Ask for the routine, not the products

"What do you use?" gets three brand names. "Your routine, morning and evening" gets order, frequency and the thing they use only sometimes — which is usually the active causing the problem.

The actives checklist beside it catches what the free text misses. Between them the esthetician arrives at the appointment already knowing whether skin can take exfoliation today.

The medical questions are short on purpose

A long medical history on a beauty intake form gets skimmed. The list here is limited to conditions that change what can safely be done to skin: isotretinoin, herpes simplex, diabetes, autoimmune and thyroid conditions, epilepsy, cancer treatment, pregnancy and keloid history.

Medications get a free box rather than a list, because the answer that matters most is often the contraceptive pill or a hormone treatment nobody thinks to include.

Sun habits predict more than most of the medical list

Daily SPF or none at all changes what pigmentation treatment is worth attempting and how quickly it will return. A client who uses a sunbed is a different treatment plan from one who does not, and neither will volunteer it unprompted.

Collect it once, before they arrive

A twenty-question intake filled in on a clipboard costs the first fifteen minutes of a sixty-minute appointment, and produces worse answers than the same form filled in at home. Sending it with the booking confirmation converts that time into treatment.

The answers come back as a spreadsheet, which means the second appointment starts from what was written the first time rather than from a folder somebody has to find. If your spa already uses its own intake form, upload that PDF and it becomes the same link with your own wording.

Ask about email separately

Appointment reminders and marketing are different permissions, and a single "may we contact you" tick box records neither properly. Three explicit options is the smallest version that is actually usable, and it means the client who wants reminders but not offers gets exactly that.

Questions people ask

What should an esthetician client intake form include?

Contact details, whether they have seen an esthetician before, their goals in their own words, main concerns and skin type, their current routine and which actives they use, a short medical list covering isotretinoin, cold sores, diabetes, autoimmune and thyroid conditions, cancer treatment, pregnancy and keloid history, medications, allergies, previous treatments, sun habits, an email preference and a dated signature.

What is the difference between an intake form and a consent form?

Intake is the history that decides which treatment to offer. Consent records that the client agreed to a specific treatment and understood its risks. Most practices collect both, and confusing them means the consent record contains no history and the intake record contains no agreement.

How far in advance should a client fill in an intake form?

With the booking confirmation, so it is answered at home with the products to hand. A clipboard at reception costs the first fifteen minutes of the appointment and produces vaguer answers.

How long should esthetician intake forms be kept?

It varies by state board and by insurer, commonly several years. Digital records are considerably easier to keep for that long and to find when a client returns after two years and you need to know what they reacted to.

Is this esthetician intake form free?

Yes. Download the PDF with no account and no email address, or send the online version with your booking confirmation.

Ready to send it out?

Every question above is already written. Make it a form, get your link, and send it. Reword anything first if your group asks it differently.

Free, no account needed to start, and the printable PDF stays one click away.

Already have your own version of this form?

You build nothing. Drop the PDF here, or photograph the printed copy, and the questions are read off it: no canvas, no dragging a box onto each field, no mapping step. The wording your organisation already approved stays exactly as it is, and you get a link that collects the answers back as a spreadsheet — and as the original document, filled in.

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