Esthetician Client Intake Form

Disclaimer: Thank you for your interest in being a client of The Beeauty Hive.

This form is used to collect information about new clients and used for internal purposes

only. The information you provide is confidential and will be treated accordingly.

Name

First Name

Last Name

Gender

Male

Female

Other

Street Address

City

State

Zip Code

Phone

(###)

###

####

How did you hear about us?

ALLERGIES & REACTIONS