By DK, Riverd Founder. Last updated: 2026-10-08.
An esthetician intake form does one job before the first facial: it tells you what is on, and under, the skin you are about to treat. A client who books a brow wax may not think to mention the acne medication she started last month. A client who books a peel may not connect the retinol serum she uses every night with the service she chose. The intake is where those facts reach you, in writing, before anyone is on the bed.
Below is a template you can copy, section by section, and a table of the extra consent questions to add for each service you offer. It is written for a solo esthetician who wants one general form for every new client and a short consent form for the treatments that carry more risk.
What should an esthetician intake form include?
An esthetician intake form should include contact and emergency details, the client's skin concerns and goals, current oral and topical medications, relevant health conditions, pregnancy, recent treatments and sun exposure, allergies and product sensitivities, and a signed statement that the information is accurate. Keep each question tied to a decision you make during the service.
That last test keeps the form short. If an answer would never change what you do, leave the question out. A shorter form is quicker for a client to finish on a phone, and every extra field is one more piece of personal information you are responsible for keeping safe.
Here is the general template. Copy it into whatever tool you use, or onto paper.
1. About you: Full name, date of birth, phone, email, emergency contact name and phone.
2. Your skin: What would you like to work on? (acne, pigmentation, dryness, sensitivity, fine lines, other). How would you describe your skin: oily, dry, combination, sensitive? Do you flush or react easily to new products?
3. Medications and topicals: Are you taking, or have you taken in the past 6 months, oral acne medication such as isotretinoin? Do you use a prescription or over-the-counter retinoid (tretinoin, adapalene, retinol)? Any other prescription skin products, antibiotics, or blood thinners?
4. Health: Any skin conditions (eczema, psoriasis, rosacea, cold sores), diabetes, autoimmune conditions, or recent surgery? Are you pregnant or breastfeeding?
5. Recent treatments: In the past month, have you had a peel, laser, microneedling, fillers, injectables, or a professional wax on the area we will treat? Any sunburn or tanning bed use in the past week?
6. Allergies and sensitivities: Any allergies to products, fragrance, latex, or adhesives?
7. Preferences: Anything that helps you relax, or that you would rather avoid (extractions, strong scents, conversation)?
8. Sign: I confirm this information is accurate and I will tell my esthetician if anything changes.
If you already use a massage intake form, you will recognize sections 1, 4, and 8. Sections 2, 3, and 5 are the esthetics-specific core, and they are the ones clients most often skip, so make them required.
What medications should an esthetician ask about?
An esthetician should ask about oral isotretinoin taken in the past 6 months, prescription and over-the-counter retinoids, other prescription skin treatments, antibiotics, and blood thinners. Ask about both pills and anything applied to the skin, and ask directly by name, because many clients do not think of a nightly serum or an acne prescription as a medication.
Isotretinoin is the clearest case. The National Library of Medicine's MedlinePlus page on isotretinoin tells patients to "plan to avoid hair removal by waxing, laser skin treatments, and dermabrasion" while taking the drug "and for 6 months after your treatment," because it raises the risk of scarring from those treatments. That is why the template asks about the past 6 months, and not just today.
Topical retinoids are the everyday version. MedlinePlus tells people using topical tretinoin to avoid unnecessary or prolonged sun and tanning beds, and not to apply it to sunburned skin or skin affected by eczema. A client using one may still be a good candidate for a facial, but you want to know before you choose products, and your own training and product manufacturer's instructions decide what you do with the answer. If a client is under a dermatologist's care, the safest answer to "can I still have this?" is to ask the doctor who prescribed it.
Do estheticians need a separate consent form for chemical peels?
Estheticians do not always need a separate form, but a short service-specific consent is the clearest way to record that a client understood a peel's risks and aftercare. Many solo estheticians keep one general intake for every new client and a separate consent for peels, waxing, dermaplaning, or microneedling, sent only to clients who book that service.
The table below lists what a service consent usually adds on top of the general intake. Treat it as a starting point and match it to your training, your products, and your state board's rules, since the services an esthetician may perform, microneedling in particular, vary by state.
| Service | Questions to add | Consent statement to add |
|---|---|---|
| Chemical peel | Retinoid use in the past week, recent waxing or laser on the area, history of cold sores, sun or tanning in the past week, any past reaction to a peel | I understand redness, flaking, and sensitivity can follow a peel, and I agree to follow the aftercare instructions, including sun protection |
| Waxing | Isotretinoin in the past 6 months, retinoids on the area, recent sunburn, skin thinning medications | I understand waxing can cause redness, bumps, or lifting of the skin, and I have told my esthetician about my skin medications |
| Dermaplaning | Active breakouts, cold sores, or rosacea flare in the area, retinoid use | I understand dermaplaning removes surface skin and fine hair and can leave skin temporarily sensitive |
| Microneedling (where your state allows it) | Recent injectables or fillers, active infection or breakout in the area, keloid scarring history, blood thinners | I understand pinpoint bleeding, redness, and swelling can follow microneedling, and I agree to follow aftercare |
| Lash or brow tint | Past reaction to hair dye, eye conditions, contact lenses, result of a patch test | I understand a patch test is recommended before tinting, and I will tell my esthetician about any eye irritation |
A consent form works best when it is specific to the service and the client signs it before the appointment, not on the bed. It also belongs in the client's record for as long as your state requires you to keep records; our guide to client records retention covers how long that tends to be and how to check your own state's rule.
How often should esthetics clients update their intake form?
Esthetics clients should update their intake form at least once a year, and again whenever their medications, pregnancy status, or skin treatments change. Before a peel or any service with a separate consent, ask a quick "anything new since last time?" even if the form is current, because a new prescription can change what is safe for that visit.
A yearly refresh catches most changes. The question at the start of each visit catches the rest, and a note in your session record ("no changes since the June intake, started adapalene 2 weeks ago") is often enough between full updates. For the reasoning behind a yearly schedule and how to ask without it feeling like paperwork, see how often clients should update their intake form.
Can clients fill out an esthetician intake form online before the appointment?
Yes, clients can fill out an esthetician intake form online before the appointment. The client opens a link on their phone, answers the questions, and signs, and the completed form reaches you before they arrive. That gives you time to read the medication answers and reschedule a peel or a wax if something rules it out, instead of finding out on the bed.
In Riverd, client intake forms are included on every plan, including Brook, which is free up to 20 appointments a month. Here is how the setup above maps onto it:
- Starting form. The first time you open intake forms, choose "Something else" instead of massage. You get a general form with contact details, a health history (including a skin conditions checkbox, medications, pregnancy, and allergies), and the signature step. Add the esthetics questions from the template by describing them to Reed, Riverd's AI assistant, for example "add a question asking whether the client has taken isotretinoin in the past 6 months." There is no form builder to learn, Undo is one click, and clients only see a change once you publish it. Reed works on the questions and never sees a client's answers.
- Three forms on the free plan. Brook and River include 3 form types with unlimited sends: for example a general intake, a peel consent, and a waxing consent. A fourth form, such as a separate microneedling consent, needs Fjord, which has no limit on form types ($49 a month billed annually, or $79 month to month).
- Each form goes to the right clients. A form can apply to every session type or only the ones you choose, so the peel consent goes only to clients who book a peel. It can send itself the first time a client books one of those sessions, and again after the number of months you pick (a 12-month re-ask covers the yearly refresh). You can also send one by hand from the client or session page, and up to three email reminders follow up until it is done.
- Signed and kept. The client fills the form on their phone with no account, login, or app, and signs with their typed name. The signed form attaches to their client record and to the session, and you can open it in the app or as a PDF. A form can also show your cancellation policy with a box the client ticks to confirm they have read it.
Two limits worth knowing before you plan around it. Riverd has no face chart and no before-and-after photo storage, and the intake form cannot collect photos, so if you chart on a face map, keep that part in the tool or paper you use now. The form editor also will not add a question asking a client for a diagnosis or an insurance ID; ask about symptoms and products instead. Intake forms are available to US practices. Riverd's esthetician booking software page covers everything else it does for skin care practices, and more on the client side of a practice is in the client experience hub.
Key Takeaways
- Keep the general intake short: every question should change something you do during the service.
- Ask about isotretinoin in the past 6 months and about retinoids by name, because clients rarely list them unprompted.
- Use a short service-specific consent for peels, waxing, dermaplaning, microneedling, and tints, signed before the visit.
- Refresh the intake yearly, and ask "anything new?" before any service with its own consent.
This is for informational purposes only and does not constitute medical or legal advice. The services an esthetician may perform, and the records you must keep, vary by state, so check with your state board and follow your product manufacturer's instructions.
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