Why do estheticians and spa therapists need a “health history” form?

Estheticians and spa therapists always want to provide the safest services to their clients, making sure that there aren't any contraindications to treatment. Smart business owners also know that they need to protect their business (and career) against the risk of liability. The perception is that by asking a million health questions, the esthetician will have enough information to know how to provide the safest service.

It's a false sense of security, however. First, clients have many reasons why they may not disclose accurate information on a health history form, and of course, health status can change at any time. Secondly, estheticians and other spa therapists aren't Regulated Health Professionals in Canada and aren't legally allowed to ask for personal health information. In fact, requesting information that is protected under the Personal Health Information Protection Act (PHIPA) could put them at risk for huge penalties. It almost makes your heart stop when you realize those penalties can be as much as $200,000 for individuals or $1,000,000 for organizations (they doubled in 2020). 

Reframing the information we ask for

What if we reframed a "health history" and made it a “client intake” to gather the information we need to build a strategy to help meet the client’s needs, interests, and challenges? This form should also meet both your LEGAL requirements and BUSINESS requirements.

• Public Health Ontario has always required that personal service providers (which include barbers, estheticians, tattoo artists, lash technicians, etc.) gather essential contact information for every client they see. This will help in the event that you need to do any contact tracing for product recalls or potential outbreaks. Plus, you need to have client information to continue to offer your services through newsletters and other marketing strategies.

• Communication preferences (and ask for permission to message them). Does your client prefer a text message, a phone call, or an email?
• Open-ended but specific questions to let them describe their challenges (whether it’s skincare or ingrown toenails) 
  • What would they like to get from their treatment? My favourite skincare question is “if you could change one thing about your skin, what would it be?”
• Any health questions should be framed so that you’re only asking about things that will impact your treatment 
  • For example, if you’re going to be offering a skincare treatment that may cause photosensitivity, you will want to know if they are already on a medication that increases photosensitivity, and you can ask “do you take any medication that causes photosensitivity or thinning of the skin?”. In this way, you’re not asking what conditions they have or what medication they take, but you’re getting the information you need.
• Ask about their homecare regimen 
  • you’ll get a sense of how much effort they want to put in, and what products they’re using.
• Disclaimer
  • explain why you're asking for the information, and how you will use it.

What about personal health information?

In Ontario, the only practitioners who are allowed to collect and be a "custodian" of personal health information are Regulated Health Professionals, such as Dentists, Doctors, Chiropractors, Massage Therapists (among a few others), and they are governed by legislation that requires:

• “use or disclosure is necessary for a lawful purpose”
• “records in their control are retained, transferred and disposed of in a secure manner”
• "make available to the public a written statement describing their information practices"

This legislation is the Personal Health Information Act, and as of 2020, the potential maximum penalty for offenses under PHIPA has doubled to $200,000 for an individual and $1,000,000 if the offender is an organization.

For more discussions around the business issues facing business owners, estheticians and spa therapists, please join us for our weekly Esthies and Their Besties virtual sessions. Learn more and register for upcoming topics.