Esthetician intake form binder with skin map, treatment log and consent

This esthetician intake form is a 24 page client binder you print at home and fill in by hand. Inside you will find a first visit questionnaire, a skin and health background page, a drawn face for mapping the skin, a blank checklist to review before treatment, treatment records, a care plan to send home and a record of past appointments. Download it instantly as US Letter and A4 PDF files.

Every client gets the same thoughtful start, and you always know what you did last time.

How the esthetician intake form supports every treatment

On three relaxed pages, new clients tell you who they are, what they want for their skin, their medical and skin background and how they care for their skin each day. Before each service you go through a blank, generic pre-treatment checklist together. The analysis page shows a drawn face divided into 10 numbered zones with an 8 symbol key, so marking breakouts, redness, dry patches or fine lines takes seconds, and follow-up maps let you compare visits side by side.

Every appointment is written up step by step in nine numbered stages, with how the skin reacted and the aftercare you gave, while the home care plan sends your client away knowing exactly what to do morning and night. Because the binder is undated and generic, it suits any studio, treatment room or service menu. Print a fresh set for each new client.

Who these client forms are for

• Licensed skin therapists and estheticians who prefer paper files beside the treatment bed
• Suite renters and solo studio owners building one consistent record for every client
• Estheticians who work from home or travel to clients and need one binder that goes everywhere
• New esthetics graduates opening a first room who want calm, organized paperwork from the start

Design and print details

• Elegant and minimal: white pages with soft blush pink accents that save ink
• Generous margins, so home printers keep every line
• Portrait US Letter and A4 pages
• Undated, so it works in any year
• Deliberately generic: no product or brand names, so it fits whatever line you use
• Keep it in a binder or on a clipboard, or have it spiral bound at a print shop

Inside the esthetician intake form binder: 24 pages

1. 1Cover showing the contents, your studio or esthetician name and the date you began the binder
2. 2Using this binder: four steps from the first appointment to every return visit, which pages to print once, each visit or when needed, and a note on privacy and on this not being medical advice
3. 3The first visit questionnaire: full and preferred name, pronouns, birthday without the year, contact details (phone, email, address), someone to call in an emergency, job, who referred them, a client number, how and when to get in touch, 12 possible reasons for coming in, 4 goals for the skin, a space for anything else and a signature
4. 4Medical and skin background: 11 questions answered yes or no with space for detail (allergies, being pregnant or nursing, prescribed creams, medicines, recent procedures, hair removal, sun exposure and more), the products used now, earlier reactions, a short note and a signature
5. 5Lifestyle and skin: how the skin feels and looks by noon, five step routines for morning and evening, time in the sun, how often they exfoliate, scales from 1 to 5 for sleep, stress, exercise and water, what they love about their skin and what they wish were different
6. 6A blank, generic review before each treatment: today's planned service, any changes since last time, 13 lines across 7 general categories with the item, a tick, the client's answer and whether it is fine to continue, any adjustments and a decision box
7. 7Studio policies and consent: 9 lines where you write your own rules for deposits and bookings, cancellations, arriving late, no-shows, payment and gift cards, 5 statements the client initials and signature lines for both of you
8. 8Photo permission note: four choices (only for the file, shared without showing the face, shared with the face, no photos at all), which areas may be photographed, where photos are stored, signatures and a line if the client changes their mind
9. 9Face map for analysis: an illustrated face split into 10 numbered zones, a note for each zone, a key of 8 symbols, skin type as observed, oil and hydration scales, top concerns and what this visit focuses on
10. 10Maps for later visits: two faces shown side by side for an earlier and a later visit, each with a date and notes, the symbol key, what changed and what to focus on next
11. 11Treatment plan: the client's goals, expectations talked through, a recommended series (number of sessions, frequency, start and review dates), home care focus, a table for 10 sessions and the agreed package or price
12. 12Treatment record: the service and room, time in and time out, checks before you start, nine stages with product type, notes and minutes, how the skin reacted, comfort scored 1 to 5, aftercare given, the next booking and your signature
13. 13Visit log: 16 lines recording the date, the service, which products or settings were used, the skin's reaction, notes and your initials, plus what works well and what to avoid or adjust
14. 14Generic product notes: 14 lines for product type, key ingredients, purpose, client response and use again, plus ingredients the client loves and ones to steer clear of
15. 15Patch tests: 10 lines for when, which product type, where on the skin, the result after, notes and initials, a key for results, a client informed line and notes
16. 16A care plan the client takes home: six step routines for morning and for evening, weekly extras, the next few days, please do, please avoid, the next visit and a personal note from you
17. 17A tracker the client takes home: daily circles over four weeks for 6 routine steps and 2 empty lines, how my skin feels and questions to bring next time
18. 18Appointment history: 20 lines showing when each visit took place, the service and who performed it, price, payment and the next booking, plus total visits, typical rhythm and missed or late appointments
19. 19Purchase history: 16 lines for date, what type of product, its size, how many, price and when to reorder, plus packages and gift cards, a wish list and samples handed out
20. 20Progress notes: six visit boxes, each with date, notes and tick boxes for photos taken or map updated, progress so far and the client's feedback
21. 21Client directory: 22 lines with each name, phone number, date of first visit, skin type, regular service and notes, plus a waiting list and this month's birthdays
22. 22Daily schedule in half hour slots from 8:00 in the morning until 7:30 in the evening, with columns for who, what service, which room, notes and a confirmed tick, plus today's prep, calls and follow-ups and the day's takings
23. 23Service menu and pricing: a 15 line table with each service's duration, cost and description, plus add-ons, packages and series and notes on prices
24. 24A lined page for notes, with a line for the client's name

Files included

• Esthetician Client Intake Form in US Letter, a 24 page PDF
• Esthetician Client Intake Form in A4, a 24 page PDF
• Read Me First, a short PDF printing guide
• Print pages 3 to 10 once for each new client. For every appointment, print new copies of pages 12, 13, 16 and 17

How to download and print

• Check out with PayPal, a debit or credit card, Apple Pay or Google Pay. Your download page opens as soon as the payment goes through.
• We email the same private download links to you, so you can download your files again later.
• Open the PDF in a free reader such as Adobe Acrobat Reader and print at 100% or Actual size.
• Print only the pages you need, as often as you like, for your own personal use.

Good to know

• This PDF is designed to be printed and completed with a pen. You cannot type into it, and it is not a hyperlinked digital planner.
• You receive a digital file only. Nothing physical is shipped.
• Colors on paper may look slightly different from your screen.
• For your personal use only. Please do not share, resell or pass on the files.
• Digital files can't be returned. If a file will not open or print correctly, email us and we will help quickly.
• The binder is a record keeping tool and not medical advice. It does not diagnose anything and does not replace your training, your license rules or what a doctor tells you.
• The two consent pages are basic templates and not legal advice. Find out what your license and local regulations ask for and change the wording to match.
• Client records are confidential. Keep the binder secure and follow the data protection rules in your workplace.

How this was made

Designed and written by PetiteDiary. AI tools helped draft parts of the text, and some background scenes in the preview images were created with AI. Every page was designed, reviewed and checked before release.

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