Medspa Intake Form Template

A medspa intake template is the editable foundation a clinic adapts to its services and supervising physician's preferences. It needs the medical history bones: identity with date of birth and emergency contact, primary care physician, named medication prompts for blood thinners, isotretinoin within the last 12 months, GLP-1 agonists, and topical retinoids; allergy list with lidocaine and anesthetic prompts; pregnancy and breastfeeding status; cold-sore history; recent dermal procedures including peels, microneedling, or laser hair removal in the treatment area; Fitzpatrick skin-type if any laser service is on the menu; and a photo-of-ID upload for first-time visits. The template also needs placeholder language for the supervising physician's name and the BAA reference so the clinic can drop in their own details before publishing.

Operators editing an intake template often miss the same items: removing the Fitzpatrick dropdown without confirming they do not offer any laser service, leaving the GLP-1 medication question off entirely because the template is older than semaglutide adoption, and forgetting to flip the photo-of-ID upload from optional to required for first-time visits. A fourth issue: the template ships with a free-text medication box that operators do not realize they should expand into named prompts.

An intake template is a draft, not a finished document. HIPAA applies once the form goes live and the vendor handling submissions must have a Business Associate Agreement on file. State med spa laws govern who can act on the data: California Business & Professions Code §2052 controls prescription delegation, Florida Board of Medicine Rule 64B8-9.0092 requires a good-faith exam. Have local healthcare counsel review the medication-prompt list, the photo-of-ID requirement, and any returning-client refresh window before publishing.

A medspa franchise with three locations might run the same intake template across all sites with location-specific supervising physician names and service menus. The template approach lets the home office update the GLP-1 medication question once and have it propagate, rather than emailing a PDF revision to every clinic manager. A solo nurse injector running a single room can also use a template, but the customization burden is lighter; the franchise model is where the editable template earns its keep.

Expect an editable intake draft with placeholder fields for supervising physician, service menu, and medication prompts. The draft is structured as a starting template you customize before publishing rather than a finished document.

A hard-coded intake PDF locks the clinic into one version forever, which fails the moment the medical director adds a new service or wants to track a new medication. A Formfy-generated template ships with the same scaffolding (identity, medications, allergies, history, ID upload) but can be edited in minutes when the menu or medication list changes. A static SOAP-NOTE-style PDF still works for clients who want paper, but the editable template is what survives the next service-menu update.