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Med Spa Consent Form Template

A med spa consent form template documents a client's informed consent before an aesthetic procedure — Botox, dermal fillers, laser hair removal, microneedling, or chemical peels. Send it by SMS, email, link, or QR code for mobile signing.

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A med spa consent form template documents a client's informed consent before an aesthetic procedure — Botox, dermal fillers, laser hair removal, microneedling, or chemical peels. It collects medical-history intake, acknowledges procedure-specific risks and contraindications, captures a photo release opt-in, and confirms post-care responsibilities. Use it before treatment so every chart has a signed, dated consent on file.

When you describe your business and how you plan to use this template, Formfy can draft a starting version that includes:

  • Procedure-specific risk language (bruising, asymmetry, pigmentation, infection) per treatment
  • Medical-history intake (medications, allergies, conditions, skin type, prior treatments)
  • Contraindication screening (pregnancy, anticoagulants, photosensitizing meds, active infections)
  • Pre-care and post-care acknowledgments per treatment type
  • Optional opt-in photo release for before/after marketing or social-media use
  • Emergency contact and primary care physician fields
  • Mobile-friendly signature block with printed name, date, and time stamp
  • Optional parent/guardian signature flow for clients under 18
  • Optional provider signature line for in-clinic provider acknowledgment

Client identity

  • Full legal name
  • Date of birth
  • Address, phone, and email
  • Emergency contact name and phone
  • Primary care physician (optional)

Medical and skin history

  • Current medications and supplements
  • Known allergies and prior allergic reactions
  • Pregnancy or breastfeeding status
  • Relevant chronic conditions (diabetes, autoimmune, bleeding disorders)
  • Skin conditions and Fitzpatrick skin type (when relevant)
  • Prior aesthetic procedures and outcomes

Procedure and consent

  • Procedure name and area being treated
  • Treatment risks specific to the procedure
  • Contraindications acknowledgment
  • Alternative treatments discussion
  • Unanticipated-outcomes acknowledgment

Pre-care and post-care

  • Pre-care responsibilities (medication pause, sun avoidance, retinoid pause)
  • Post-care responsibilities (ice, makeup avoidance, sun avoidance)
  • When to call the clinic for complications

Optional photo release

  • Opt-in for before/after marketing photos
  • Opt-in for social-media use
  • Opt-in for training and education use

Signature

  • Client signature with printed name and date
  • Optional parent or guardian signature for clients under 18
  • Optional witness or provider signature
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Once your consent form is ready, send it to clients the way they actually open links — by SMS, email, public link, or QR code. Clients tap the link on their phone, review the consent, complete intake, sign on any device with a finger or stylus, and submit. Signed PDFs land in your Formfy dashboard in real time with a full audit trail (IP, timestamp, signer info, signature geometry). Search by client, procedure, or date when you need to retrieve a record.

Every template is a starting point — open it in the Formfy editor to add or remove fields, reword clauses to match your jurisdiction and procedure mix, add your clinic logo and brand colors, set notifications, and connect SMS or email delivery before you publish. Review consent language with qualified counsel and licensed medical professionals before going live.

Formfy does not provide legal or medical advice. Med spas and aesthetic clinics should review consent forms with qualified counsel and licensed medical professionals. Treatment risks, contraindications, aftercare, and consent language should match the procedure, the licensed provider, and the jurisdiction. Many states recognize electronic signatures as legally equivalent to handwritten signatures under E-SIGN and UETA, but informed-consent requirements for medical and aesthetic procedures vary by state and procedure type.

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