Nutrition Intake Form

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Client intake forms are crucial for nutrition and health coaches.

They help to create a baseline of where the client is at in terms of their nutrition and lifestyle habits, as well as provide an opportunity for the coach to get to know the client's health history and goals.

This guide will show you what to include in a nutrition intake form, how to use it to be a better coach and some tips for making the most of this valuable tool.

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What is a Nutrition Intake Form?

A nutrition intake form is a document that provides information about a person's diets and lifestyle habits.

It can be used to assess someone's current eating habits and identify areas where they may need to make changes. It can also be used to track progress over time.

Elements in a Nutrition Intake Form

There are many different ways to format a nutrition intake form. However, there are some basic elements that should be included:

Basic information

Asking for basic information such as the client's name, address, contact details and date of birth is important. This will help you to identify the person and keep track of their progress over time.

It helps with appointment scheduling and can be useful if you need to contact the client outside of normal consultation hours.


An important part of nutrition coaching is helping clients to set realistic goals like ideal weight, eating more vegetables, or reducing their intake of processed foods.

Asking about their goals on the intake form will give you a good starting point for discussions during the consultation.

It will also help you to identify any areas where the client may need extra support. Areas such as weight loss, eating more healthily, or increasing physical activity levels can be addressed through goal setting.

Nutrition and lifestyle habits

In order to provide tailored nutrition advice, it is important to understand a client's current diet and lifestyle habits that may affect their health.

Asking questions like if they eat breakfast every day, how often they eat fast food or how much water they drink each day will give you a good overview of their current eating habits.

It is also important to ask about any food allergies or intolerances, as this can help to tailor the advice you give.

Health history

Asking about a client's health history is important for two reasons. Firstly, it helps you to understand any medical conditions that may need to be taken into account when giving nutrition advice.

Secondly, it can help to explain any lifestyle factors that may be contributing to health problems.

For example, a history of heart disease may indicate that the client needs to make dietary changes to reduce their risk of further problems.

Tips for Making the Most Out of Client Intake Form

  • Make the form easy to fill out.
  • Use the form to build rapport.
  • Use the form to assess progress.
  • Use the form to make referrals.
  • Keep the form confidential.
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