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Med Spa Intake & Screening Forms, IV Therapy, Injectables (Fillable PDF + Canva)

Includes Etsy Purchase Protection
  • Medical director's full name and credentials (MD, DO, NP, PA) and practice name. Orders without it are refunded.

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Highlights

  • Party decor for gatherings and celebrations
  • Digital download
  • Digital file type(s): 1 PDF

For practices with a medical director: every document here is a blank framework your medical director completes and signs.

Med spa intake form template set: one master intake and health history form plus seven service-specific screening addendums for IV hydration, vitamin and nutrient therapy, performance and energy services, aesthetic injectables, esthetics and peels, energy-based devices, and mobile or offsite visits. Fillable Canva plus print-ready PDF.

Every document is a framework. It is not usable until your medical director completes, reviews, and signs it. Purchase does not create a clinical protocol, delegation, or supervision arrangement, and does not satisfy your state's requirements on its own. Not legal or medical advice.

Every screening addendum lists the categories a screening covers and gives you the documentation fields. It never states a threshold, cutoff, contraindication, or disposition. Those are blanks your accountable prescriber completes.

IN THE DOWNLOAD
- Master intake and health history, 4 pages, 10 blocks including a prescriber evaluation field
- 7 service screening addendums, 2 pages each: screening categories, practice decision fields, documentation fields, signatures
- Jurisdiction Verification page, intended use statement, how-to-use page, license
- Editable Canva template link (free Canva account works)
- 23 pages, US Letter, PDF

This is Section 2 of the Core Operations Manual, sold on its own. The complete manual is listed separately.

For use by licensed medical professionals under medical director oversight. This is a framework document: clinical decisions, thresholds, and jurisdictional requirements are blank fields your accountable prescriber completes and signs. It does not reflect the laws of any particular state and includes a Jurisdiction Verification page for your own review. Single-clinic license, one physical location. Includes editable Canva template access; sign-off blocks and the license page are locked by design. Frameworks are reviewed on a published schedule and updates are included with your purchase.

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