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Esthetician Client Intake Form
I need an Esthetician Client Intake Form for my new high-end spa in London, with particular emphasis on medical history collection and liability waivers for advanced skin treatments, including micro-needling and chemical peels.
1. Personal Information: Collection of client details including full name, contact information, date of birth, and emergency contact details
2. Medical History: Comprehensive health questionnaire covering current medications, allergies, medical conditions, and pregnancy status
3. Treatment Consent: Client acknowledgment and agreement to treatment, including risks and potential outcomes
4. Privacy Notice: GDPR-compliant explanation of how personal data will be collected, processed, stored and protected
1. Photo Consent: Optional authorization for taking and using before/after photographs for treatment tracking or marketing purposes
2. Patch Test Declaration: Documentation of patch testing results and client acknowledgment for treatments requiring sensitivity testing
3. Treatment History: Record of previous beauty treatments, results, and any adverse reactions
1. Schedule A - Treatment Price List: Comprehensive list of available treatments and their current pricing
2. Schedule B - Aftercare Instructions: Detailed post-treatment care guidelines for various services
3. Schedule C - Cancellation Policy: Terms and conditions for appointment cancellations, rescheduling, and associated fees
Authors
Medical History and Health Conditions
Allergies and Sensitivities
Current Medications
Treatment Consent
Privacy and Data Protection
Liability Waiver
Emergency Contact Information
Photo Consent
Treatment History
Skin Condition Assessment
Cancellation Policy
Client Declaration
Treatment Disclaimer
Information Sharing
Health and Safety
Patch Testing Requirements
Aftercare Acknowledgment
Payment Terms
Record Keeping
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