QuestionPunkQuestionPunk
無料で始める
すべてのテンプレート
Industry-Specific

Body Contouring Client Intake & Goals Assessment

A pre-consultation intake for body contouring and non-surgical fat reduction clients, covering treatment areas of interest, goals, health history flags, and expectations. An AI follow-up interview explores what's driving the request and probes any flagged health history so providers walk into the consultation prepared, not surprised.

このテンプレートを使うほかのテンプレートを見る

設問の例

テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。

全14問・約7分
Q01
メッセージ

Welcome! Before your body contouring consultation, we'd like to understand your goals, health history, and expectations so we can recommend the right treatment plan. This takes about 5-6 minutes, and everything you share stays confidential with your care team.

Q02
選択式必須

Which areas are you hoping to address? (Select all that apply)

  • Abdomen
  • Flanks / love handles
  • Thighs
  • Arms
  • Back
  • Chin / neck
  • Buttocks
Q03
選択式必須

What's the primary result you're hoping to achieve?

  • Reduce stubborn fat
  • Tighten loose or sagging skin
  • Smooth cellulite
  • Improve overall body contour or shape
  • Build muscle definition
  • Not sure yet - exploring options
Q04
選択式必須

Do any of the following apply to you? (Select all that apply — this helps us flag anything we should discuss before treatment)

  • Currently pregnant or breastfeeding
  • Pacemaker or implanted electronic device
  • History of blood clots or clotting disorder
  • Active skin infection or open wound in the treatment area
  • Recent surgery in the treatment area (last 6 months)
  • Autoimmune condition
Q05
自由回答（長文）

Please list any current medications, supplements, or medical conditions we should know about (e.g., blood thinners, diabetes, recent significant weight changes).

Q06
選択式必須

Have you had body contouring treatments before (at our practice or elsewhere)?

  • No, this is my first time
  • Yes, one treatment
  • Yes, multiple treatments
  • Not sure what counts as body contouring
Q07
オピニオンスケール必須

How dramatic a change are you expecting to see in the treated area?

スケール: 1 – 7
最小:Very subtle refinement最大:Dramatic transformation
Q08
評価スケール必須

How important is having little to no downtime after treatment?

範囲: 1 – 5
最小:Not important最大:Extremely important
Q09
選択式必須

When are you hoping to start treatment?

  • As soon as possible
  • Within the next month
  • 1-3 months from now
  • Just researching, no timeline yet
Q10
AIインタビュー

Explore what's driving this respondent's interest in body contouring right now — a specific event, a plateau despite diet and exercise, or something else — and how they define 'success' in concrete terms (clothing fit, photos, confidence). If they flagged any health history item, gently confirm the details so the provider has enough context before the consultation. If their stated expectations sound more dramatic than a single non-surgical treatment typically delivers, note this clearly so the provider can set expectations early.

Q11
同意

Progress photo consent

Q12
選択式

What's your age range?

  • 18-24
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65+
  • Prefer not to say
Q13
選択式

How do you describe your gender?

  • Woman
  • Man
  • Non-binary
  • Prefer to self-describe
  • Prefer not to say
Q14
メッセージ

Thank you for sharing this with us! Your answers help your provider tailor a treatment plan and consultation just for you — this information stays in your confidential client file and is only used for your care team's planning.

含まれる機能

  • AIによる深掘り

    自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。

  • 注意確認設問

    急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。

  • AIが作成する設問文

    文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。

  • 自動レポート

    回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。

他ツールとの比較

ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。

このテンプレートを選ぶ理由

  • Includes a dedicated multiple-choice question flagging health history conditions, paired with a open-text follow-up for medications/supplements/conditions so providers aren't caught off guard
  • Uses an AI follow-up interview to explore what's actually driving the client's interest in body contouring right now, going beyond static answer choices
  • Captures both aesthetic expectations (rating-scale on how dramatic a change they expect, rating on downtime tolerance) and logistics (timing, treatment areas, prior treatments) in one flow
  • Includes explicit progress photo consent and demographic questions (age range, gender) alongside a warm welcome and closing conversational message, so the intake feels guided rather than clinical-cold

Jotform

Body Contouring Client Intake Form Template

A static, fielding-ready intake form built specifically for body contouring clients, likely covering treatment areas and basic health history in a fixed question set. As a form builder, Jotform lets you customize fields and branding but does not conduct any live follow-up conversation with respondents.

優れている点

  • Purpose-built for body contouring intake, so field naming and flow match the use case
  • Easy drag-and-drop customization and integration with Jotform's broader form ecosystem
  • Likely supports e-signature/consent widgets given Jotform's general form feature set

物足りない点

  • Static question set with no adaptive follow-up probing on flagged health history or motivations
  • No automated per-response quality scoring or AI-generated consultation-ready reports
  • No transparent, inspectable AI prompts since there is no AI interview component

SurveySparrow

Body Contouring Client Intake Form Template

A conversational-style, fielding-ready template targeted at the same body contouring intake use case, leveraging SurveySparrow's chat-like survey format. It likely presents questions one at a time for a friendlier feel, but the questions themselves remain fixed rather than adapting based on answers.

優れている点

  • Conversational one-question-at-a-time format may feel more approachable to clients
  • Template is niche-matched to body contouring, reducing setup work
  • Part of a broader survey platform with reporting/analytics dashboards

物足りない点

  • No adaptive AI follow-up interview to explore motivations or dig into flagged health conditions
  • No voice AI interview or guided screen-share task option
  • Lacks automated per-response quality scoring or transparent AI prompt methodology

よくあるご質問

「Body Contouring Client Intake & Goals Assessment」テンプレートにはどのような設問が含まれていますか？

すぐに使える設問が14問含まれており、最初の設問は次のとおりです：「Welcome! Before your body contouring consultation, we'd like to understand your goals, health history, and expectations…」・「Which areas are you hoping to address? (Select all that apply)」・「What's the primary result you're hoping to achieve?」。すべての設問は上でプレビューでき、自由に編集できます。

このアンケートの回答にはどのくらい時間がかかりますか？

回答者は通常、14問を約7分で回答し終えます。

テンプレートは編集できますか？

はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。

このテンプレートは無料で使えますか？

はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。

公開の準備はできましたか？

このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。

このテンプレートを使う無料で始める

関連テンプレート

似たテーマのほかの調査もご覧ください。

すべて見る
Industry-Specific

Post-Presentation Audience Feedback Survey

Captures how a presentation, talk, or webinar landed with its audience — clarity, pacing, relevance, and delivery — for presenters, event teams, and internal comms who want to improve the next session. An AI follow-up digs into the exact moment attention was lost or a point clicked, going beyond generic satisfaction scores.

テンプレートを見る
Industry-Specific

Facial Treatment Client Intake & Skin Consultation

A pre-appointment intake for estheticians, spas, and skincare clinics that captures skin type, primary concerns, safety-relevant history (retinoids, recent peels, allergies), and treatment goals — with an AI follow-up that digs into the story behind the client's main concern so the esthetician walks in prepared, not guessing.

テンプレートを見る
Industry-Specific

Massage Therapy New Client Intake Assessment

A pre-session intake for massage and bodywork clients that captures health history, contraindications, areas of tension, and treatment goals so therapists can plan a safe, effective session. An AI follow-up interview digs into the client's primary concern — onset, triggers, and what's already been tried — so therapists walk in with context instead of a blank form.

テンプレートを見る
Industry-Specific

Personal Training Client Intake & Goal Assessment

A new-client intake for personal trainers and coaches that captures training goals, current fitness level, injury/medical history, scheduling needs, and consistency barriers before the first session. An AI follow-up interview digs into the real motivation and biggest obstacle behind the client's stated goal so the trainer can program around it from day one.

テンプレートを見る
Industry-Specific

Esthetician Client Skin Intake & History Survey

A pre-appointment intake for estheticians and skincare studios that captures skin type, concerns, allergies, contraindications, and treatment goals before a first visit — with an AI follow-up that digs into any past reactions or unclear answers so the esthetician walks in fully briefed instead of re-asking basics on the table.

テンプレートを見る
Industry-Specific

Fitness Client Intake & Goal-Setting Survey

Captures a new fitness client's goals, exercise history, health considerations, and scheduling needs before their first session, with an AI follow-up that uncovers what derailed past attempts and what accountability will make this program stick. Built for personal trainers, gyms, and coaching apps onboarding new clients.

テンプレートを見る