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Medical Questionnaire – Health & Wellness

Business Owner: If you are offering any sort of health services, you can have your clients fill out this questionnaire before servicing them. A medical questionnaire is important for helping providers and/or aestheticians learn and understand a potential client’s medical history, current issues, and possible risks in order to protect the business from liability and allow the provider to offer the client the most appropriate and safest level of care.

How to Use this Form:

  1. Download the Word Document (so that the document can be edited).
  2. Read through the ENTIRE AGREEMENT at least once before editing. (Become familiar with the form and any documents you may need).
  3. Revise the HIGHLIGHTED Information and make any provisions as needed.
  4. Delete any NOTES that may be written.
  5. Confirm that ALL parties are identified. Execute (Sign) the Agreement.
  6. Confirm that the page numbers are accurate.
  7. Keep a COPY of the Signed Agreement in your files.