Get Esthetics Intake Form Pdffiller

Completing the Esthetics Intake Form is an essential step for users seeking skin care treatments. This guide provides a clear, step-by-step approach to filling out the form online, ensuring you provide the necessary information to receive appropriate care.

Follow the steps to complete the form effectively.

1. Click the ‘Get Form’ button to access the Esthetics Intake Form and open it in your preferred online platform.
2. Fill in your name, date, and address in the designated fields, ensuring all information is accurate and complete.
3. Input your contact details, including your home and work/cell phone numbers, profession, email address, and date of birth.
4. Provide the name and phone number of an emergency contact.
5. Indicate how you heard about the service by checking the appropriate box or writing in another source.
6. Answer the question about previous professional skin care treatments by selecting 'Yes' or 'No' and specifying the type if applicable.
7. Detail any medical care received within the past year from a physician or dermatologist if the answer is 'Yes.'
8. List any medications, supplements, or herbal/homeopathic remedies you are currently taking.
9. Respond to the question about using topical medications or exfoliating acids by selecting 'Yes' or 'No' and providing further details if applicable.
10. Indicate if you have ever had an adverse reaction to cosmetic products, providing an explanation if you answer 'Yes.'
11. Describe your current facial cleansing and moisturizing routine.
12. Report any special treatments you are currently using.
13. Rate the overall quality of your skin on the provided scale.
14. List the improvements you would like to see in your skin.
15. Circle your tendency to burn in the sun based on the options provided.
16. Record your daily water intake.
17. Rate your current stress level on the scale of 1 to 10.
18. Circle all applicable conditions for which you have been treated.
19. Indicate whether you wear contact lenses and if you are currently wearing them.
20. Provide details if you wear any hormone or nicotine patches.
21. Note if you are bothered by scents, oils, or lotions, explaining if necessary.
22. Answer whether you use any specified skin medications and provide details about the timeframe of their use.
23. Answer the questions regarding allergies or previous adverse reactions to food or products.
24. Review all the information entered for accuracy.
25. Once all fields are completed, save your changes, and then download, print, or share the completed form as needed.

Start filling out your Esthetics Intake Form online today to take the first step towards your skin care journey.