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Client Information

Name

Medical History

Dietary Information

Lifestyle and Eating Habits

The Nutrition Consultation Form Template by WPForms is a great tool for nutritionists, trainers, health coaches, and anyone looking for a simple way to onboard new clients and make their nutrition consultation process as smooth as possible.

How Does the Nutrition Consultation Form Template Work?

The Nutrition Consultation Form Template requires the WPForms Basic License since it uses numerous Fancy Fields to gather comprehensive insights into clients’ dietary habits and health history.  Here’s a brief description of the fields included in the template:

  • Client Information:
    • Name: Collects the client’s full name for personalization.
    • Date of Birth: Helps understand the age-related dietary needs.
    • Gender: Offers insight into gender-specific nutrition requirements.
    • Phone Number & Email Address: Essential for seamless communication with the client.
  • Medical History:
    • Current Health Conditions: To identify what items to include in the nutrition plan.
    • Allergies: Highlights food allergies to avoid in dietary recommendations.
    • Medications Being Taken: Considers the impact of medications on nutrient absorption.
    • Previous Surgeries: Informs about any medical history that might affect dietary needs.
  • Dietary Information:
    • Current Diet Pattern: Gives a baseline of the client’s eating habits.
    • Food Preferences & Dietary Restrictions: Helps tailor the diet plan to the client’s likes.
    • Current Weight & Weight Goals: Sets the foundation for goal-oriented nutrition.
    • Height: Used to calculate BMI and personalize dietary advice.
    • Favorite & Least Favorite Foods: Ensures the diet plan is enjoyable for the client.
  • Lifestyle and Eating Habits:
    • Smoking Habits & Alcohol: Lifestyle choices that affect nutritional needs.
    • Exercise Routine: Integrates physical activity levels into the dietary plan.
    • Meal Frequency & Typical Portion Sizes: Assesses eating patterns and portion control.
    • Fluid Intake: Evaluates hydration levels and provides recommendations.

Sign up with WPForms today and access the Nutrition Consultation Form Template. It is ideal for nutritionists, dietitians, and health coaches seeking an effective way to collect client information and transform their onboarding experience.