Free Worksheet

Great outcomes start with the right intake. Every single time.

Download this free intake form now!

One print-ready page. Every question a facial aesthetic consultation requires — structured for real clinic flow, designed to protect both provider and patient from the first appointment forward.

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★Free PDF

What's inside?

Pre-treatment sections for medical history, current medications, and known allergies
Dedicated fields for cosmetic goals, prior aesthetic treatments, and patient expectations
Single-page format that keeps facial consultations focused without skipping anything important
Print-ready and laminate-friendly — sized for standard clinic clipboards and ready to use today

hey there!

I'm Ellen

I'm a board-certified dermatologist and aesthetic medicine educator — though my pets would argue my true calling is professional belly-rub giver. When I'm not helping providers master their craft (confidence up, overwhelm down), you'll catch me recording podcast episodes, wandering off to explore a new country, or swearing I'll finally relax on this trip... before heading right back to work helping people look and feel confident.