Esthetician Consent Form Template
Collect health history and consent from clients before any esthetic treatment begins.
Esthetic treatments can affect the skin in meaningful ways — especially for clients on certain medications, with active conditions, or recovering from procedures. This consent form gives estheticians the background they need to perform services safely and confidently.
The template covers the client's contact information, current skin concerns, relevant medical conditions and medications, recent procedures or treatments, known sensitivities or allergies, sun exposure and lifestyle factors, the specific service being consented to, and a signed acknowledgment of treatment risks.
A client who's fully consulted before a treatment is more likely to be satisfied with the result — and less likely to blame unexpected reactions on the esthetician when the real cause was an undisclosed medication or condition.
Retinoids, blood thinners, photosensitizing medications, acne medications like isotretinoin, and some antibiotics can all affect how skin responds to treatments. Chemical peels, lasers, and microneedling in particular require careful screening.
Before the first appointment and updated at each subsequent visit. Skin, medications, and health conditions change — a quick confirmation that nothing has changed is the minimum update required at each session.
Active skin infections or lesions at the treatment site, recent surgical procedures, active cancer treatment, open wounds, certain autoimmune conditions, and known sensitivities to specific ingredients or equipment.
A comprehensive intake covers all services. For new clients, collect the full history. For returning clients, use a brief update form. Some specialized treatments — chemical peels, lash lifts, microdermabrasion — may need additional specific consent sections.
That the client provided accurate health information, understands the treatment and its potential risks, has had an opportunity to ask questions, and agrees to proceed. For treatments involving potential adverse reactions, be specific about what those reactions might be.
Get inspired by relevant templates and categories
3200+ Templates, 300+ Integrations
With Typeform, you can 
customize everything
Change text, colors, and even logos to match the look and feel of your brand. Then embed forms smoothly onto web and email.
Make forms feel effortless to fill out. Pace questions, call people by their name, and adapt the flow based on the data they share.
Stay efficient by connecting forms to your workflow. Typeform integrates with 300+ tools including Slack, Zapier, and HubSpot.
