Template library · Intake forms
Esthetician Intake template
Please complete before your skincare appointment.
- 16 fields across 3 sections
- Included with MyWellOps
- Edit it, or save your own version
What’s in it
- DateDate
- PractitionerText
Contact Info
- Full nameText
- Date of birthDate
- Phone numberText
- EmailText
Skin Profile
- Skin typeChoice
- OtherText
- Product allergies or sensitivitiesText
- Current skincare products/routineText
- Daily sun exposureChoice
- Skin concerns (check all that apply):
- Acne
- Aging/fine lines
- Hyperpigmentation
- Redness/rosacea
- Dehydration
- Sensitivity
Treatment Goals
- Prior facial/skin treatments (e.g. peels, laser)Text
- Are you pregnant or nursing?Choice
- What would you like to achieve today?Text
- Client signatureSignature
- Date signed (client)Date
When to use it
Send an intake form when a new client books, so their history, contact details and reasons for coming are in front of you before the first appointment rather than taken down during it.
How it works in MyWellOps
- Choose it from Documents and adjust the questions to your practice.
- Send it to the client, who completes it in their client portal.
- Their answers are kept on the client’s record, ready for the first session.
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