Med Spa Intake Form Templates and Field Checklist

Your med spa intake form should collect exactly what you need at each stage — and nothing more. In practice that means two or three different forms, not one: a short public booking or consult form that lives on your website and turns browsers into booked clients, a deeper new-client health-history intake sent securely after someone books, and a treatment-specific consent intake for injectables, laser or peels. Below are ready-to-copy layouts for all three as plain field lists, the exact questions to ask and why, the HIPAA-aware best practices that keep completion rates high while protecting health data, and where to put each form so people actually find it.

The reason to split intake into stages is not only conversion — it is safety and privacy. A browsing prospect and a booked client have very different tolerance for questions, so a twelve-field form on your public site loses people in seconds. But there is a second reason unique to a clinic: medical history, medications and allergies are sensitive health information that has no business sitting on an open, public-facing form. Design for both realities and your booking rate, your data quality and your privacy posture all improve at once.

What should a public booking form include?

This is the form that sits on your public site and social links. Its only job is to capture the enquiry and get someone booked, so keep it to five or six fields and collect no clinical detail at all.

• Full name [text, required]
• Email [email, required]
• Phone [phone, required]
• Treatment of interest [dropdown: Injectables, Laser, Facials / skin, Body contouring, Not sure — help me choose]
• Preferred date or time [date / text]
• How did you hear about us? [dropdown, optional]

That is enough to book a consult, route the enquiry and follow up. The treatment dropdown lets you triage instantly and send the right clinical intake later, and the "not sure" option captures the prospect who is curious but undecided — often your best consult opportunity. Notice what is absent: no health conditions, no medications, no pregnancy question. None of that belongs on a public form. For the wider picture of turning visitors into booked clients, see how to capture leads with forms.

What does a new-client health intake need?

Once someone has booked, motivation is high and the deeper questions are justified — and, crucially, you can now collect them through a secure, consented channel rather than an open web page. This form gathers what you need to treat safely.

• Full name [text, required]
• Date of birth [date, required]
• Email [email, required]
• Phone [phone, required]
• Are you currently pregnant or breastfeeding? [radio: Yes, No, Prefer not to say]
• Known allergies [long text]
• Current medications and supplements [long text]
• Relevant medical conditions [checkboxes: Skin conditions, Autoimmune, Diabetes, Blood-clotting / on blood thinners, Cold sores / herpes, None of these]
• Prior aesthetic treatments [checkboxes: Injectables, Laser, Peels, None]
• Recent treatments in the last two weeks [long text, optional]
• Skin concerns and goals [long text]
• Consent to collect and store this health information [checkbox, required]
• Anything else we should know? [long text, optional]

This form should be delivered through a secure link after booking — not embedded on a public page. The pregnancy, medication and blood-thinner questions are not box-ticking: they directly change what is safe to perform, which is exactly why they belong in a protected clinical intake rather than an open form. The prior-treatment checkboxes let a provider plan around recent injectables or laser work, and the explicit consent checkbox both respects the client and creates a record that consent was given.

What does a treatment consent intake need?

Consent is treatment-specific and needs capturing close to the appointment. A short, focused form per procedure does that cleanly.

• Client name [text, required]
• Treatment being performed [dropdown, required]
• I understand what this treatment involves [checkbox, required]
• I have read the common risks and side effects [checkbox, required]
• I understand the aftercare instructions [checkbox, required]
• I confirm the health information I provided is accurate and current [checkbox, required]
• Photography consent for before / after records [radio: Yes, No]
• Client signature [signature]
• Date [date, auto]

Captured digitally, this consent is timestamped and stored against the client record instead of living on a paper form in a folder. The "photography consent" radio is worth keeping separate — many clients are happy to be treated but not photographed, and forcing one answer to cover both is neither respectful nor clear. The accuracy-confirmation checkbox ties the consent back to the health intake, so the provider knows the history they are relying on was affirmed at the point of treatment.

Which fields matter, and why ask them?

Every field on an intake form should earn its place. Here is the reasoning behind the core ones.

What are the best practices for a med spa intake form?

Keep the public form short. Five or six fields converts far better than a dozen. Split intake into a light public booking form and a fuller clinical intake, so browsers answer little and booked clients answer more.

Keep PHI off the public form. This is the rule that matters most for a clinic. Medical history, medications, allergies and pregnancy status are sensitive health data — collect them only on a secure new-client intake sent after booking, never on an open web page. If your clinic falls under HIPAA, confirm your form and CRM vendor will sign a business associate agreement and configure the tools accordingly.

Design mobile-first. Most people will fill it out on a phone, often straight from an Instagram or Facebook link. Use a single column, large tappable fields, labels above inputs, and the right keyboard type for each field. Anything that forces pinching and zooming loses bookings.

Make consent explicit. On the clinical intake, ask clearly for permission to collect and store health information, and capture treatment consent as its own step before the appointment. Digital consent that is timestamped and stored against the record beats a paper form in a drawer every time.

Automate the follow-up. A form is only as good as what happens after submit. Wire it so every booking creates a contact, sends an instant confirmation, delivers the secure intake link and raises a reminder before the appointment. Speed matters: a prospect who gets an instant, personal reply is far likelier to keep the booking than one who waits. For the wider retention picture, the ready-made win-back campaign ideas for med spas show how the same automation brings lapsed clients back.

Confirm and set expectations. End the booking form with a clear thank-you screen that tells the person what happens next and when — a confirmation text, the intake form on its way, the consult time confirmed. A submitter left staring at a blank success message often wonders whether it worked at all.

Where should you embed each form?

Give the public booking form its own dedicated page you can link to from the home page, every treatment page and the contact page, and use as a landing page for social ads. Embed a short version inline on your busiest treatment pages too. The clinical intake and consent forms are different: those go out by secure link after booking, not on the open site. The test for the public form is simple — anyone ready to book should reach it in one click from wherever they are, including straight from a social bio link. For the broader playbook, see med spa marketing and the Med Spa & Aesthetics Marketing hub.

What tool should host the form?

You can build these in a standalone form builder and manually chase bookings, but then the follow-up, reminders and intake links all live somewhere else. One option that keeps everything in one place is HighLevel, which hosts the public booking form, routes each submission straight into a CRM contact record, books the consult and fires automated follow-up — the confirmation, the secure intake link, the reminder before the appointment. Honestly, the value is less about the form itself and more about not stitching a form tool, a booking calendar, a CRM and an SMS platform together: forms, scheduling, CRM and automation in one system means a booking never falls through a gap between apps. If that fits how you want to work, you can start a free HighLevel trial and build the booking form and follow-up in an afternoon. Whatever you choose, confirm it can handle health data appropriately before any clinical detail flows through it.

Whichever tool you use, the structure is the same: a short public booking form with no clinical detail on it, a secure health-history intake sent after booking, treatment-specific consent captured before the appointment, and automated follow-up so nothing slips. Get that right and your intake stops being a bottleneck and starts being the smoothest, safest part of winning a client. If you want a hand wiring it up, see our pricing or book a call.