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すべてのテンプレート
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.

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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13問・約7分
Q01
メッセージ

Welcome! Before your appointment, we'd like to learn a bit about your skin, history, and goals so your esthetician can tailor your treatment safely. This takes about 5 minutes, and everything you share stays in your confidential client file.

Q02
選択式必須

How would you describe your skin type?

  • Oily
  • Dry
  • Combination
  • Normal
  • Sensitive
  • Not sure
Q03
選択式必須

What skin concerns would you like addressed? Select all that apply.

  • Acne or breakouts
  • Fine lines or wrinkles
  • Hyperpigmentation or dark spots
  • Redness or rosacea
  • Dullness or uneven texture
  • Enlarged pores
  • Dehydration or dryness
Q04
選択式必須

Do you have any known allergies or sensitivities to skincare ingredients (e.g., fragrance, essential oils, retinoids, latex)? Select all that apply.

  • Fragrance or essential oils
  • Latex
  • Retinoids (e.g., Retin-A, retinol)
  • Chemical exfoliants (AHA/BHA)
  • Certain metals or adhesives
Q05
自由回答（長文）必須

List any prescription skincare, oral medications, or recent procedures that could affect your treatment (e.g., Accutane, Retin-A, chemical peels, blood thinners, recent Botox or filler).

Q06
選択式必須

Are you currently pregnant, nursing, or managing any skin condition (e.g., eczema, active infection) your esthetician should know about before treatment?

  • Yes
  • No
  • Prefer not to say
Q07
選択式

Which professional skincare treatments have you had in the last 12 months? Select all that apply.

  • Chemical peel
  • Microdermabrasion or dermaplaning
  • Laser or light therapy
  • Injectables (Botox or filler)
  • Facial extractions
Q08
オピニオンスケール必須

In the last 30 days, how often did you wear sunscreen on days you were outside for more than 7 minutes?

スケール: 1 – 5
最小:Never最大:Every day
Q09
ベスト・ワースト選択（MaxDiff）必須

When it comes to your skin, which goals matter most to you right now?

  • Reduce acne or breakouts
  • Minimize fine lines and wrinkles
  • Even out skin tone
  • Calm redness or sensitivity
  • Improve hydration
  • Refine pore appearance
  • Achieve an overall healthy glow
各セットで最も良いもの・最も悪いものを選択最も良い:Most important to me最も悪い:Least important to me
Q10
AIインタビュー

Probe the respondent's most important skin goal and any allergy, medication, or condition they flagged: ask what specifically triggered past reactions or breakouts, how their skin responded to their most recent professional treatment, and what 'success' would look like for them after a series of appointments. If they said 'not sure' about skin type or left history vague, ask concrete questions (how their skin feels by midday, whether it changes seasonally) to pin it down before treatment.

Q11
同意必須

Before/after photo consent

Q12
選択式

What is your age range?

  • 18-24
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65+
  • Prefer not to say
Q13
メッセージ

Thank you for sharing your skin history with us! Your esthetician will review this before your appointment so your first session can start with a treatment plan, not a questionnaire.

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

  • Captures skin type, concerns, allergies, contraindications, recent procedures, and treatment goals in one structured intake before the appointment
  • Includes an AI follow-up interview that probes the respondent's top skin goal and digs deeper into any flagged allergy, medication, or reaction detail instead of leaving it as a vague text answer
  • Uses a max-diff exercise to force-rank what the client actually cares about most, plus a dedicated before/after photo consent step and pregnancy/skin-condition screening question
  • Ends with a clear, friendly close so the esthetician walks into the first appointment already briefed instead of re-asking basics on the table

Jotform

Esthetician Client Intake Form Template

A static, fielding-ready intake form template specifically built for estheticians, likely covering skin type, concerns, and basic history fields. It sits inside Jotform's large form-builder library with standard drag-and-drop customization. There's no indication of any adaptive follow-up beyond fixed form logic.

優れている点

  • Purpose-built for the esthetician audience
  • Backed by a mature, widely-used form builder with easy customization
  • Likely supports e-signature/consent-style fields common to intake forms

物足りない点

  • No adaptive AI follow-up to probe unclear allergy or reaction answers — respondents just fill fixed fields
  • No automated per-response quality scoring or AI-generated debrief report for the esthetician
  • No transparent, published interview-prompt methodology since it's a static form, not an interview

SurveySparrow

Free Esthetician Client Intake Form Template | Consultation Forms

A free, conversational-style intake template positioned under SurveySparrow's healthcare consultation forms category, aimed at capturing client skin history in a chat-like UI. It's a ready-to-field template rather than an adaptive interview. Being free is a plus, but depth of follow-up is limited to whatever branching logic is manually built in.

優れている点

  • Conversational one-question-at-a-time format that may feel friendlier than a plain form
  • Free to use, lowering the barrier for small studios
  • Positioned within a healthcare/consultation template category, suggesting relevant field coverage

物足りない点

  • No AI-driven follow-up that adapts to a specific allergy or reaction mentioned — only pre-set branching, if any
  • No automated quality scoring of responses or auto-generated summary report
  • No voice AI interview option for clients who prefer speaking over typing

Typeform

Esthetician Client Intake Form Template

A polished, conversational one-question-per-screen template tailored to estheticians, well suited to a clean client-facing intake experience. It's a static template that relies on Typeform's standard logic jumps rather than true adaptive AI. Good for first-visit basics but not for probing follow-up on flagged concerns.

優れている点

  • Clean, mobile-friendly conversational UI well matched to client-facing intake
  • Esthetician-specific template, so field set should already match the use case
  • Established logic-jump features for basic conditional branching

物足りない点

  • No AI follow-up interview capable of digging into vague or concerning answers in real time
  • No per-response quality scoring or automated report generation for the esthetician
  • No transparent published prompt/methodology since there is no AI interviewing layer

SurveyMonkey

Client Intake Form Template

This is a generic client intake form template, not one built specifically for estheticians or skincare history, so it would need meaningful customization to cover skin type, allergies, or contraindications. It's a static, fielding-ready form from a broad survey platform rather than a niche or adaptive tool. Useful as a generic starting point but not purpose-built for this audience.

優れている点

  • Backed by a well-known, broadly capable survey platform
  • Easy to customize generic intake fields for many industries
  • Straightforward reporting/analytics on standard question types

物足りない点

  • Not esthetician- or skincare-specific out of the box, unlike a purpose-built skin intake template
  • No adaptive AI follow-up to probe allergy, medication, or reaction details
  • No automated quality scoring or AI-generated summary report for the practitioner

よくあるご質問

「Esthetician Client Skin Intake & History Survey」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13問含まれており、最初の設問は次のとおりです：「Welcome! Before your appointment, we'd like to learn a bit about your skin, history, and goals so your esthetician can t…」・「How would you describe your skin type?」・「What skin concerns would you like addressed? Select all that apply.」。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、13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

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