Esthetician Client Intake Form Template for Australia

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Key Requirements PROMPT example:

Esthetician Client Intake Form

"I need an Esthetician Client Intake Form for my new mobile beauty therapy business launching in March 2025, which must include specific sections for home-visit safety protocols and be compliant with Australian regulations while being fillable on a tablet device."

Document background

The Esthetician Client Intake Form is a fundamental document required for all new clients seeking esthetic treatments in Australia. This form must be completed prior to any treatment services and serves multiple purposes: gathering essential client information, documenting medical history and contraindications, establishing treatment preferences, and ensuring compliance with Australian privacy laws and healthcare regulations. The document is designed to protect both the service provider and client by creating a comprehensive record of the client's health status and treatment history, while adhering to the Privacy Act 1988 and relevant state-specific beauty industry regulations. It forms part of the client's ongoing treatment record and must be regularly updated to maintain accurate information.

Suggested Sections

1. Client Personal Information: Basic contact details including name, address, phone, email, emergency contact, and preferred method of communication

2. Medical History: Comprehensive health information including current medications, allergies, medical conditions, and recent surgeries that could affect treatment

3. Skin Assessment: Current skin conditions, concerns, routine, and products used

4. Treatment History: Previous cosmetic treatments, reactions to treatments, and current skincare routine

5. Lifestyle Factors: Sun exposure, diet, stress levels, and other factors affecting skin condition

6. Privacy Statement: Information about how client data will be collected, stored, and used in compliance with Privacy Act 1988

7. Client Acknowledgment: Client's confirmation that provided information is accurate and agreement to update the provider about any changes

Optional Sections

1. Pregnancy Status: Required for clients who may be pregnant or nursing, as certain treatments may be contraindicated

2. Photographic Consent: Optional section for clients to consent to before/after photos for treatment tracking or marketing purposes

3. Marketing Preferences: Optional section for clients to indicate preferences for receiving promotional materials and updates

4. Service-Specific Questions: Additional questions specific to specialized treatments like laser therapy or chemical peels

5. Insurance Information: Required if treatments may be claimed through health insurance

Suggested Schedules

1. Treatment Consent Form: Detailed consent form for specific treatments to be administered

2. Skin Type Assessment Chart: Fitzpatrick scale and other skin classification tools

3. Medical Referral Form: Template for obtaining medical clearance when required

4. Product Sensitivity Test Record: Documentation of patch tests and sensitivity checks

5. Treatment Plan Template: Customizable treatment planning document based on intake information

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Personal Information
Medical History
Privacy and Confidentiality
Consent
Health and Safety
Disclosure
Emergency Contact
Treatment History
Liability
Medical Disclosure
Photography Rights
Information Update
Records Access
Risk Acknowledgment
Treatment Authorization
Data Protection
Communication Preferences

Relevant Industries

Beauty and Wellness

Medical Aesthetics

Spa Services

Cosmetic Services

Healthcare Services

Personal Care Services

Professional Services

Relevant Teams

Operations

Client Services

Legal and Compliance

Quality Assurance

Front Desk

Treatment

Medical Records

Customer Relations

Relevant Roles

Esthetician

Beauty Therapist

Spa Manager

Clinic Director

Skin Care Specialist

Medical Esthetician

Compliance Officer

Beauty Salon Owner

Treatment Coordinator

Client Services Manager

Quality Assurance Manager

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Let's create your Esthetician Client Intake Form

Authors

Alex Denne

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