By the Templateez Team · Licensed Attorney · June 2026

Medical Spa Intake Forms: What Med Spas Need to Capture at New Client Intake

A medical spa is not a day spa with better marketing. It is a medical practice — one that performs procedures capable of causing vascular occlusion, post-inflammatory hyperpigmentation, scarring, and systemic complications. The intake process needs to reflect that reality. A client who walks in requesting lip filler and discloses nothing about their autoimmune condition, their Accutane history, or the hyaluronidase dissolution they had six months ago is a client your provider is treating blind. And treating blind in aesthetics is how adverse events happen.

Most med spas collect a name, date of birth, and a vague "reason for visit" line. That is not intake — that is check-in. A real medical spa intake form captures the clinical detail your providers need to select appropriate treatments, set safe parameters, identify contraindications before the client is in the chair, and protect the practice from liability when a complication arises despite proper care. Here is what that form should include.

Patient demographics and treatment goals

Demographics in a med spa context go beyond standard contact information. Age, biological sex, and ethnicity all influence treatment selection, product choice, and risk profiles. A 28-year-old seeking preventative neurotoxin and a 62-year-old seeking volume restoration for mid-face hollowing are fundamentally different clinical presentations, and your intake should capture enough context to frame the consultation before the provider enters the room:

• Full contact information — name, date of birth, address, phone, email, emergency contact. Standard but essential. Emergency contact matters here more than in most service businesses because anaphylaxis and vascular events, while rare, require immediate escalation.
• Primary skin concerns — wrinkles and fine lines, volume loss, hyperpigmentation, acne and acne scarring, textural irregularity, rosacea, body contouring goals, skin laxity, unwanted hair. Let the client check all that apply — most aesthetic clients have multiple concerns, and the treatment plan often addresses several simultaneously.
• Aesthetic goals in the client's own words — a free-text field where the client describes what they want to achieve. This is clinically valuable because it reveals expectation alignment. A client who writes "I want to look like I did ten years ago" has different expectations than one who writes "I want subtle improvement around my eyes." The provider needs to see this language before the consultation, not discover it mid-appointment.
• Treatment history — prior aesthetic procedures (injectables, laser, chemical peels, microneedling, surgical), where they were performed, approximate dates, results, and any complications. This is not optional. A client who had filler placed by another provider and does not disclose it is a client your injector may inadvertently over-treat or place product in a compromised vascular zone.
• Before-and-after documentation consent — consent to clinical photography for the medical record. This is separate from social media consent and should be captured at intake because baseline photos are needed before the first treatment, not after.

Medical history with aesthetic relevance

A standard medical history form misses the conditions that matter most in aesthetic medicine. General practice intake asks about heart disease and diabetes. Med spa intake needs to ask about those and the conditions that specifically contraindicate or complicate aesthetic procedures:

• Autoimmune conditions — lupus, scleroderma, rheumatoid arthritis, dermatomyositis. These conditions affect wound healing, increase the risk of abnormal scarring, and may contraindicate certain energy-based devices and injectable fillers.
• Keloid or hypertrophic scarring tendency — a client with a history of keloid formation is a poor candidate for procedures that create controlled skin injury (microneedling, ablative laser, deep chemical peels). This must be assessed before treatment planning, not discovered when a scar develops.
• Bleeding disorders and anticoagulant use — hemophilia, von Willebrand disease, or therapeutic anticoagulation. Injectables, microneedling, and any procedure that breaches the skin surface carry elevated bruising and bleeding risk in these patients.
• Active infections — herpes simplex virus (HSV) is the critical one. A client with a history of oral HSV who undergoes perioral laser resurfacing or a chemical peel without antiviral prophylaxis is at high risk for a herpetic outbreak that can cause significant scarring. Active bacterial infections in the treatment area are absolute contraindications.
• Pregnancy or nursing — most injectable neurotoxins, certain lasers, and many chemical peel agents are contraindicated during pregnancy and lactation. This is a screening question, not a treatment-day question.
• Diabetes — impaired wound healing, increased infection risk, and altered inflammatory response. Poorly controlled diabetes is a relative contraindication for procedures that rely on normal healing.
• Immunosuppression — whether from medication (transplant recipients, autoimmune disease treatment) or condition (HIV/AIDS). Immunosuppressed clients heal differently, have higher infection risk, and may have atypical responses to energy-based devices.
• History of cancer — especially skin cancer (melanoma, basal cell carcinoma, squamous cell carcinoma). Active malignancy in or near a proposed treatment area is a contraindication. Prior skin cancer requires careful evaluation of treatment sites.
• Connective tissue disorders — Ehlers-Danlos syndrome, Marfan syndrome. These affect skin elasticity, healing, and response to energy-based treatments in ways that standard intake forms do not capture.

If your intake process overlaps with dermatology practice intake, that is by design. Med spas operate in the same clinical territory — the difference is that dermatology intake is built around diagnosis and medical necessity, while med spa intake is built around elective treatment selection and contraindication screening.

Current skincare regimen

What a client is putting on their skin right now determines what you can safely do to that skin today. This is not a lifestyle question — it is a clinical safety screen:

• Active products — retinoids (tretinoin, adapalene, retinol), alpha and beta hydroxy acids (glycolic, salicylic, lactic), hydroquinone, vitamin C serums, benzoyl peroxide. Each of these affects the skin barrier, and several require a washout period before certain procedures. A client using tretinoin nightly who presents for a medium-depth chemical peel without disclosure is at risk for a burn injury.
• Recent procedures — chemical peels, laser treatments, microneedling, or dermabrasion within the past two to four weeks. The skin's barrier function may still be compromised, and stacking procedures too closely causes cumulative injury that exceeds the skin's repair capacity.
• Sun exposure and tanning — recent sun exposure, tanning bed use, and sunless tanners (DHA-based products). Tanned skin changes melanin distribution, which directly affects laser parameter selection and increases the risk of burns and dyspigmentation. Sunless tanners can cause uneven absorption of certain chemical peels.
• Isotretinoin (Accutane) history — isotretinoin use within the past six months is a contraindication for most ablative procedures, chemical peels, waxing, and aggressive resurfacing. The drug fundamentally alters sebaceous gland function and wound healing for months after discontinuation. Your intake must capture not just whether the client has used it, but when they stopped.

Treatment-specific screening

Different aesthetic procedures carry different risk profiles, and your intake needs to capture the specific clinical details that inform each treatment category. A single generic form does not work here — the information that matters for injectables is different from what matters for laser, which is different from what matters for body contouring:

• Injectables (dermal fillers) — prior filler types and brands (hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, polymethylmethacrylate), injection locations, dates, volumes, complications (nodules, migration, vascular compromise), and any history of vascular occlusion. A client who experienced a vascular event from prior filler is a high-risk client who requires modified technique, awareness of existing product placement, and immediate access to hyaluronidase.
• Neurotoxin — prior Botox, Dysport, or Xeomin treatments, including units injected, areas treated, duration of effect, and any adverse reactions (ptosis, asymmetry, antibody resistance). Dosing history helps your injector calibrate units for the individual client's metabolism and muscle mass.
• Laser and energy-based devices — Fitzpatrick skin type assessment is critical. This is not cosmetic classification — it determines laser wavelength selection, energy density, pulse duration, and cooling parameters. Fitzpatrick types IV through VI carry significantly elevated risk of post-inflammatory hyperpigmentation and require conservative parameter settings, longer intervals between treatments, and often different device selection entirely. Your intake must capture this, not leave it to a visual estimate in the treatment room.
• Body contouring — BMI, target treatment areas, prior body contouring procedures (CoolSculpting, liposuction, radiofrequency), and realistic outcome expectations. Body contouring devices reduce subcutaneous fat in targeted areas — they are not weight loss solutions, and clients who present with a BMI above the device manufacturer's recommended range need to understand this before consenting to treatment.
• Chemical peels — peel depth assessment (superficial, medium, deep), prior peel history, Fitzpatrick type (again — deeper peels in darker skin types carry substantial PIH risk), and any history of adverse reactions to peeling agents.

Medication and supplement review

Medications and supplements affect bleeding, healing, photosensitivity, and immune response — all of which directly impact aesthetic procedure safety and outcomes. Your intake must capture a complete list, not just prescription medications:

• Blood thinners — warfarin, heparin, apixaban, rivaroxaban. Also aspirin and NSAIDs (ibuprofen, naproxen), which many clients do not think to disclose because they consider them routine. All increase bruising risk with injectables and any procedure that breaches the skin.
• Supplements that increase bleeding — fish oil, vitamin E, ginkgo biloba, garlic supplements, turmeric, ginger in high doses. Clients take these daily and rarely connect them to bleeding risk. Your intake needs to ask specifically, not rely on a generic "list your supplements" field that gets left blank.
• Photosensitizing medications — tetracyclines (doxycycline, minocycline), fluoroquinolones, retinoids, thiazide diuretics, certain antifungals. A client on doxycycline for acne who undergoes IPL or laser treatment without disclosure is at elevated risk for burns and hyperpigmentation.
• Immunosuppressants — methotrexate, biologics (adalimumab, etanercept), corticosteroids. These alter the healing cascade and infection risk profile for any procedure that creates a wound.

Allergy screening

Allergy documentation in a med spa goes beyond the standard "are you allergic to any medications" question. Aesthetic procedures involve topical anesthetics, adhesives, latex, and product-specific ingredients that require targeted screening:

• Lidocaine or other local anesthetic allergies — topical numbing creams (lidocaine, prilocaine, benzocaine) are used before most injectable and many energy-based procedures. A true amide anesthetic allergy requires alternative pain management protocols.
• Latex allergy — relevant for glove selection and any latex-containing supplies that contact the client's skin during procedures.
• Adhesive tape allergy — tape is used post-procedure for wound care, securing dressings, and during certain treatments. Adhesive sensitivity requires hypoallergenic alternatives.
• Specific product ingredient allergies — hyaluronic acid filler ingredients, chemical peel components, topical product ingredients. While true allergy to hyaluronic acid is rare, hypersensitivity to the lidocaine mixed into many filler syringes is not.

Photography consent and social media authorization

Clinical photography and social media usage require separate, distinct consents. Many med spas conflate them, which creates both a compliance problem and a trust problem with clients who consent to clinical documentation but do not want their face on Instagram:

Clinical before-and-after photography. This is a medical record function, not a marketing function. Baseline photos are essential for treatment planning, progress tracking, outcome documentation, and defense against malpractice claims. Consent for clinical photography should be captured at intake because the first set of photos needs to be taken before the first treatment. Refusing clinical photography does not prevent treatment, but your provider should document the refusal and explain how it limits their ability to track outcomes.

Social media and marketing consent. This is a separate authorization — separate form, separate signature, separate right to revoke. The client consents (or does not consent) to the use of their before-and-after images on the practice's social media accounts, website, advertising materials, and third-party review platforms. This consent should specify which platforms, whether images will be anonymized or identifiable, and how the client can withdraw consent after granting it.

Informed consent per procedure

Informed consent in a med spa is not a blanket waiver. Each procedure carries its own risk profile, expected outcomes, recovery timeline, and contraindications. Your intake process should establish the framework for procedure-specific consent, even if the detailed consent is signed on the day of treatment:

• Risks specific to the procedure — bruising, swelling, asymmetry, infection, scarring, hyperpigmentation, vascular compromise (for injectables), burns (for laser), paradoxical adipose hyperplasia (for cryolipolysis). Generic risk language is not adequate. The client must be informed of the specific risks associated with their specific treatment.
• Expected downtime — social downtime versus medical downtime. A neurotoxin client has zero downtime. A medium-depth chemical peel client has five to seven days of visible peeling. A laser resurfacing client may have two weeks of redness and swelling. These timelines must be disclosed before consent, not after.
• Number of sessions typically needed — many aesthetic treatments require a series. Laser hair removal requires six to eight sessions. Microneedling for acne scars may require three to six. IPL for pigmentation may require three to five. A client who consents to one session expecting complete correction has not been adequately informed.
• Post-procedure care instructions — sun avoidance, activity restrictions, product restrictions, follow-up appointments. These should be reviewed before consent so the client can assess whether the aftercare requirements fit their schedule and lifestyle.

Financial disclosure and payment structure

Medical spa services are elective. Insurance does not cover them. Your intake should establish this clearly and present the financial structure so there are no surprises:

• Elective service disclosure — a clear statement that aesthetic treatments are not medically necessary, are not covered by health insurance, and that the client is financially responsible for all costs.
• Treatment packages and membership programs — many med spas offer package pricing (buy five sessions, receive a discount) or monthly membership programs with included treatments and product discounts. The terms, expiration policies, and cancellation rules for these programs should be disclosed at intake.
• Financing options — CareCredit, Cherry, Alphaeon, or other third-party financing. If you offer financing, disclose it at intake so clients can plan for multi-session treatment costs. Financing is subject to credit approval, and the terms (interest-free promotional periods, deferred interest) should be referenced, not detailed — the financing provider handles the specifics.

HIPAA compliance: not optional for med spas

This is the point that too many medical spas get wrong. A med spa is a medical practice. It is supervised by a licensed physician (or in some states, a nurse practitioner or physician assistant with collaborative agreements). It performs medical procedures. It maintains medical records. It is subject to HIPAA — the Health Insurance Portability and Accountability Act — in exactly the same way a dermatology office or a plastic surgery practice is subject to HIPAA. The "spa" in the name does not create an exemption.

Your intake process must include:

• Notice of Privacy Practices (NPP) — a written notice describing how the practice uses and discloses protected health information. The client must receive this notice and acknowledge receipt at intake. This is a federal requirement, not a best practice.
• Authorization for release of medical records — if the client's treatment plan involves coordination with a referring physician, dermatologist, or primary care provider, you need a signed authorization to share records. This is especially relevant when a client's medical history includes conditions (autoimmune disorders, cancer history, bleeding disorders) that require coordination with their treating physician before aesthetic procedures can safely begin.
• Privacy and data security — before-and-after photos, treatment records, and payment information are all protected health information. Your intake should note how this information is stored, who has access, and the client's rights under HIPAA (access, amendment, accounting of disclosures).

For a deeper look at HIPAA requirements in intake form design, see the HIPAA-compliant intake forms guide, which covers Notice of Privacy Practices, minimum necessary standard, authorization forms, and the specific compliance obligations that apply to any medical practice collecting protected health information — including medical spas.

Building trust from the first touchpoint

A medical spa intake form that asks about Fitzpatrick skin type, isotretinoin history, filler brand and placement, and HSV status tells the prospective client something important: this practice understands aesthetic medicine at a clinical level. It signals that the provider behind the intake process has treated enough patients to know which questions prevent complications, which disclosures protect the client, and which omissions create risk. That signal is what separates a credible medical practice from a business that happens to own a laser.

If you are building documentation across a healthcare practice, the Healthcare Bundle includes medical spa and aesthetics alongside 20 other healthcare specialties, each with specialty-specific intake fields and HIPAA-compliant structure.