Confidential Intake Form Skin Care Esthetics (Canada)

Form Template

This Confidential Intake Form Skin Care Esthetics (Canada) Mobile App is a form template containing both a questionnaire and consent form for clients about to undertake skin care / esthetic procedures.

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The beginning of the form contains usual client information, like address and phone number, and then moves to a questionnaire. The questions cover if the client has any history of previous treatments, current medications, and any adverse reactions to treatments previously. This app also covers current skin care routines, such as if the client has been treated for a number of diseases or conditions, specific skin medications, and allergies. As an esthetician performing treatments, the questions on this template are completely customizable to suit your company.

As a skin care professional, use this client intake form to gather key information that helps prevent any allergic reaction and be aware of other factors like cold sores, contact lenses, and any other skin conditions. Better understand your clients to ensure best health practices and safe skin treatments and procedures, while promoting strong privacy practices.

This consent form stipulates that the client has supplied accurate information as well as agreeing to notify the skin therapist if any information changes during prolonged treatment. It states that the client will inform the therapist if they experience any pain or discomfort during the procedure.

Use this app's reporting feature to run convenient report PDFs, exportable and shareable in real time.

You might also want to check out some of our other popular esthetician client intake forms.

  • Signature Capture
  • Conditional Fields
  • Submission Editing
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