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New Client Intake


Please fill out this form prior to booking your first skincare, facial, or bodywork service at Ritual. This form is a one-time request for new clients only.

Contact Information

Medical History

Medical Conditions (check all that apply)


Do you eat or drink any of the following at least 1x a week? (check all that apply)
Are you experiencing any of the following? (check all that apply)

Skin Assessment

Do you have sensitivites to any of the following? (check all that apply)
Have you had any of the following procedures? (check all that apply)

Waiver of Liability

I understand that with any treatment certain risks are involved and that any complications from known or unknown causes could occur.

I understand that possible side effects include, but are not limited to: mild to moderate redness, mild to moderate peeling or flaking, stinging, dry skin, tenderness, pimples, cold sores or allergic reactions. Most side effects are temporary and will dissipate within 3-7 days.

I do not have active cold sores.

I will call to inform my skincare professional of any complications or concerns I may have as soon as they occur.

I understand that it is recommended prior to having a facial infusion to not have used Retin A for 48 hours, Accutane in 6 months, or have waxed 24 hours prior to receiving treatment.

I have read and completed this questionnaire truthfully. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from treatments received. The treatments I receive are voluntary, and I release the company and/or skin care professional from liability.

Thanks for submitting! You'll hear from us soon.

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