What this intake form does for med spa owners and aesthetic clinic managers
An editable Word + PDF template built for med spas, aesthetic clinics, and injectors.
This template collects registration details, practice-specific questions (insurance or treatment goals), a check-box health history, medications and allergies, current concerns, and a signed acknowledgment. Open it in Word or Google Docs, replace the bracketed placeholders with your company name, logo, prices, and terms, and it's ready to use on your next job.
The intake form is the first document in every client relationship and the one that feeds all the others. The details collected here (names, addresses, contact preferences, history, the reason for the call) flow directly onto the estimate, the agreement, the invoice and the follow-up messages. Get it right once and the rest of the paperwork fills itself in.
It also prevents wasted visits. Ten focused questions asked before a dermal filler consultation tell a med spa what to bring, how long to allow and what the client actually expects, and a signed authorization at the bottom prevents the most common dispute of all: 'I never agreed to that.'
What is inside the template
- Company header block for your name, logo, phone, email, website and license number
- Client contact and preferred-contact-method section
- Property, equipment or health-history section written for Med Spa work
- Reason for visit / chief complaint with structured checkboxes and free-text notes
- Scheduling, access and special-instruction fields
- Plain-language authorization statement with signature and date lines
How to use it (step by step)
- Open the .docx in Word or Google Docs and replace the bracketed placeholders in the header with your company details. Save this as your master copy.
- Decide how you will use it: printed on a clipboard, filled on a tablet, or sent as a PDF before the appointment.
- Collect it before the work starts. For phone bookings, the office can complete the top half and the client signs on arrival.
- Attach the completed form to the job record so the estimate and invoice reference the same details.
Common mistakes this template helps you avoid
- Asking for a signature without an authorization statement above it, which makes the signature meaningless.
- Using a generic form that skips the Med Spa-specific questions that determine what work is actually needed.
- Collecting the form after the job, when it no longer protects anyone.
Expert tips from the field
- Add a 'how did you hear about us' field. It is the cheapest marketing analytics you will ever run.
- Keep a one-page version for emergencies and a full version for scheduled first visits.
- Review the form once a year against the questions your team actually asks on the phone; the form should match reality.
Why med spa owners and aesthetic clinic managers choose this over a generic template
Generic forms are written for nobody in particular. This one was written for medical spas and aesthetic clinics: the fields, wording and clauses reflect real med spa work such as a neurotoxin appointment for forehead lines or a dermal filler consultation. It uses plain language clients can read, it has a header block for your logo and license number, and it matches the other Med Spa templates in the set so your intake, consent, policy and checklist documents look like one system.
Explore the full Med Spa template collection and paperwork guide, or see how it fits with the related documents below.
