MUST HAVES FOR YOUR INTAKE FORM

What is included in your intake form? When was the last time you even looked at it? Is it a copy of a copy of a copy that is given to patients on an antiquated clipboard? Or rather is it a high-tech version used on an iPad?

If you’re still using paper, it’s time to consider whether that is really the best method for your practice to get the information you need from each patient. The use of staff time to input all patient details, increased margin for error, and confusion resulting from having to decipher handwriting is not very efficient in the digital age.

Here is what should be on an intake form:

  • Name
  • Address
  • Street, City, State, Zip
  • Home, work, cell – preference for how to be contacted
  • Email
  • Occupation
  • Primary physician
  • Referred by
  • Family history – checklist – maternal/paternal, etc.
  • Smoking history – checklist
  • Medical history – checklist
  • Surgical history
  • Treatment history – checklist
  • Skincare history – checklist
  • Current and past medications taken – checklist of common medications that are of concern to an aesthetic practice
  • Allergies to medications – checklist of common medications
  • Present symptoms
  • Reason for the visit – complete checklist

The more detailed the form, the better. Not all cosmetic patients will fill out every question, but it is helpful to include all of these categories in the event that they do. It also forces the patient to think through their medical history, medications, allergies, etc. to avoid surprises.

To make it easier for the patient and speed up the process, include checklists for each relevant section, and add OTHER: _____________.

Some of these fields can be created with a drop-down menu, such as state, surgical history, etc.

Under Reason for Visit, include a checklist of ALL services offered and an ‘OTHER’ field. This can be a valuable tool for new consultations who may not realize the extent of the services, products, treatments you feature in your practice.

Include a downloaded PDF version of this form on your website so patients can complete the paperwork in advance to save time at their visit. If your office sends confirmation emails or texts to patients for their visit, include a link to the intake form for new consults to complete before they arrive.

Lastly, many practices today do a deep dive about patients prior to their first consultation. For example, they check them out online, on Facebook, Instagram and other social platforms to take note of any red flags before the individual enters the practice.

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