Nutrition Coaching Form template

Start nutrition coaching with the client's goals, eating habits, dietary needs and activity level.

Healthcare template · 11 fields (7 required) · ~3 min for respondents to complete · Free plan · No credit card · Fully customizable

Set up your nutrition coaching form

Start nutrition coaching with the client's goals, eating habits, dietary needs and activity level.

Use it for coaching, not diagnosis: refer clients with medical conditions to their doctor or a registered dietitian, and keep responses visible only to the coach.

The form separates age, main goal, dietary preferences, food allergies or intolerances (optional) into labeled questions. Review the choices and required fields for your organization before sharing it.

Best practices

• Use it for coaching, not diagnosis: refer clients with medical conditions to their doctor or a registered dietitian, and keep responses visible only to the coach.
• Customize the age and main goal questions to match your records and terminology.
• Name the team that reviews responses and explain what happens after submission. A requested date, service or approval is not automatically confirmed.
• Ask only for information needed for this step. Arrange any sensitive supporting documents through an appropriate private process.

Every field, explained

• Your name (Name, required)
• Email address (Email, required)
• Age (Number)
• Main goal (Dropdown, required)
• Dietary preferences (Multiple choice)
• Food allergies or intolerances (optional) (Long text)
• Activity level (Dropdown, required)
• What does a typical day of eating look like? (Long text, required) — Meals, snacks and drinks from morning to night, with rough times.
• Coaching format (Single choice, required)
• Diets or programs you've tried before (optional) (Long text)
• Acknowledgment (Multiple choice, required)

Frequently asked questions

What does this nutrition coaching form template collect?

Alongside contact details, it asks for age, main goal, dietary preferences, food allergies or intolerances (optional), activity level, what does a typical day of eating look like?, coaching format, diets or programs you've tried before (optional), acknowledgment. You can rename questions, change choices and remove fields that your workflow does not need.

How should I use this nutrition coaching form form?

Use it for coaching, not diagnosis: refer clients with medical conditions to their doctor or a registered dietitian, and keep responses visible only to the coach.

Can I edit this form and print a copy?

Yes. Open an editable draft, adjust the questions, and review the preview before publishing. You can also use the template page’s print option. Publishing requires an account; the draft can be tried first.

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