Esthetician Intake Form: What to Ask Every New Client

1. Contact and basic identifying information

This one seems obvious, but it's worth noting what "basic" actually includes for estheticians. Beyond name, phone, and email, your intake should capture:

• Date of birth — relevant for product selection, hormonal considerations, and age-related contraindications
• Preferred pronouns — important for inclusive practice and client comfort
• Emergency contact — relevant for clients with known medical conditions
• How they heard about you — useful for business tracking

2. Skin classification

Before you can meaningfully assess a client's concerns, you need a baseline skin profile. These questions anchor everything that follows:

• How does your skin feel within an hour of cleansing — tight, comfortable, or shiny? (helps identify true skin type)
• Do you tend to get shiny primarily in the T-zone, all over, or rarely?
• Would you describe your skin as sensitive? Does it react easily to new products?
• Have you ever had an allergic or irritation reaction to a skincare product?

You'll form your own assessment of their Fitzpatrick type and Glogau score during the skin analysis — the intake form captures self-reported baseline so you can compare it against your clinical findings.

3. Primary skin concerns and goals

Ask clients to identify their top concerns rather than list everything that bothers them. Prioritization helps you understand what they're actually coming to you for versus secondary issues they're aware of. Good questions include:

• What is the primary skin concern that brought you here today?
• Are there secondary concerns you'd like addressed over time?
• Have you received professional treatments for these concerns before? What was done?
• What does success look like for you — what would make this worth it?

4. Health and medication history

This is the most clinically important section of the intake form and the one most often done inadequately. Skipping or skimping here creates genuine liability. You need to ask about:

Medications that affect treatment decisions

• Accutane (isotretinoin) — current use or within the last 6–12 months is a contraindication for many treatments
• Topical or oral retinoids — affects chemical peel candidacy and exfoliation tolerance
• Blood thinners or anticoagulants — bruising risk for any treatment with pressure or extractions
• Immunosuppressants — wound healing and infection risk
• Hormonal medications — can affect acne, pigmentation, and skin sensitivity
• Chemotherapy or radiation (current or recent)

Medical conditions relevant to skin treatment

• Active skin conditions: eczema, psoriasis, rosacea, perioral dermatitis, seborrheic dermatitis
• Autoimmune conditions: lupus, scleroderma, Sjögren's syndrome
• Diabetes — affects wound healing
• Thyroid disorders — can affect skin texture and sensitivity
• Cold sores or herpes simplex — relevant for treatments that can trigger outbreaks
• Recent surgeries, injuries, or procedures in the treatment area

Recent aesthetic procedures

• Botox or neurotoxin injections — timing matters for massage and facial pressure
• Dermal fillers — specific contraindications for certain treatment modalities
• Laser or IPL treatments
• Chemical peels (professional grade)
• Microneedling
• Permanent makeup or microblading

5. Current skincare routine

A client's home routine tells you how their skin has been conditioned, what active ingredients it's already tolerating, and what gaps exist in their care. Ask specifically:

• What products are you using morning and evening? (cleanser, toner, serum, moisturizer, SPF)
• Are you using any active ingredients at home — retinol, vitamin C, AHAs/BHAs, niacinamide, benzoyl peroxide?
• How consistent is your SPF use?
• Have you experienced any reactions to products you've used recently?

6. Lifestyle factors

Lifestyle questions help you understand systemic factors that influence skin health and treatment outcomes. The most relevant ones:

• How would you rate your stress level on a typical week?
• Do you smoke or vape?
• How much water do you drink daily?
• How much sun exposure does your skin typically get?
• Are you pregnant or trying to conceive? (affects product selection and treatment safety)

7. Consent and acknowledgments

Every intake form should close with a signed consent section that includes:

• Confirmation that all disclosed information is accurate and complete
• Agreement to notify the esthetician of any changes to health status or medications
• Acknowledgment of contraindications (if applicable to specific treatments)
• Photo consent — if you capture before/after images
• Data privacy acknowledgment — how their information will be stored and who can access it
• Signature with timestamp and device confirmation

If you're using a digital intake form, the timestamp and device confirmation are often captured automatically. A consent signature with no date or IP confirmation has limited legal value if a client ever disputes what they disclosed.

The form is a starting point, not a destination

The intake form captures what's true on day one. What changes — and it always does — needs to be documented too. A client who starts a retinoid three months after intake, gets Botox, or develops a new skin condition is functionally a different treatment candidate than the one who filled out that original form. Your intake record should be easy to update across visits, not a static snapshot that sits untouched while the clinical reality changes around it.

The best intake systems for estheticians link the intake record directly to the session note: at the start of each visit, you review what's changed, update the record, and proceed with a current understanding of the client in front of you. That's the standard worth building toward.