BoomCloud FormsBy BoomCloud™

Med Spa New Client Intake

Client intake covering goals, skin history, medications, and lifestyle factors that affect treatment planning.

Preview Form
  • 7 days free
  • Cancel any time
  • 10 languages
  • No patient data stored on our servers
Fields
12
Practice type
Med Spa
Languages
English
Editable
Yes — add, remove and reword fields
Sharing
Print, PDF or a secure link

Med Spa New Client Intake — preview

Sample layout generated from the actual template.

Full Namerequired
Date of Birthrequired
Phone Numberrequired
Emailrequired
What are your aesthetic goals?required
Treatments of Interest
InjectablesLaserMicroneedlingPeelsSkincareBody Contouring
Are you pregnant or breastfeeding?required
YesNo
Allergies
Current medications and supplements
How did you hear about us?
ReferralGoogleSocialOther
Signaturerequired
Daterequired

Free to start — your edits are saved as you go.

About this form

The med spa new client intake is a patient intake document used by med spa practices. Client intake covering goals, skin history, medications, and lifestyle factors that affect treatment planning. In BoomCloud Forms it is a starting point: every field, heading and statement can be edited before you share it with patients.

Practices may use this template as a starting point and should review the wording against their own professional, regulatory and legal requirements before use.

What's included

This template ships with 12 fields:

  • Full NameText
  • Date of BirthDate
  • Phone NumberText
  • EmailText
  • What are your aesthetic goals?Long answer
  • Treatments of InterestMultiple choice
  • Are you pregnant or breastfeeding?Single choice
  • AllergiesLong answer
  • Current medications and supplementsLong answer
  • How did you hear about us?Single choice
  • SignatureSignature
  • DateDate

When practices use it

Med Spa teams typically attach this form to the new-patient workflow, sending it before the first appointment so the front desk has complete records on arrival. It can be sent digitally ahead of the visit, completed on a tablet in the office, or printed as a PDF.

How to customize it

  • Reword any question, add fields, or remove ones your practice doesn't need.
  • Apply your practice name, logo and colors so the form matches your brand.
  • Switch to another supported language where a translated version exists.
  • Share a secure link with the patient, or download a print-ready PDF.

Not ready yet? Email me this template

We'll send a link to the Med Spa New Client Intake so you can come back to it later.

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Med Spa New Client Intake

7 days free · No card required to start