Modulo di Ammissione Clienti Nutrizione Gratuito
Un modulo di ammissione completo e stampabile per i nuovi clienti di nutrizione. Copre anamnesi, preferenze alimentari, allergie, stile di vita e obiettivi. Stampa o salva come PDF gratuitamente.
Click print to save as PDF or send directly to your printer.
Nutrition Client Intake Form
Please complete all sections before your first consultation. All information is kept confidential.
Personal Information
Body Measurements
Health Goals
Medical History
Dietary Preferences and Restrictions
Lifestyle
Typical Daily Eating Pattern
Additional Notes
I confirm the information above is accurate to the best of my knowledge.
Send digital intake forms through Foodzilla
Replace paper forms with digital client onboarding. Foodzilla lets you send customisable intake forms to new clients before their first appointment. Responses are stored securely in each client profile so you can review them any time.
Why a thorough intake form sets up every consultation for success
A well-designed intake form means you arrive at every first consultation prepared. You already know your client's health history, what they can and cannot eat, and what they are trying to achieve. That lets you spend your session time on advice and connection rather than collecting basic information.
Medical history and medication fields are particularly important. Conditions like coeliac disease, type 2 diabetes, PCOS, and hypothyroidism all require specific dietary approaches, and some medications affect how nutrients are absorbed. Reviewing this before the appointment allows you to prepare targeted recommendations.
The dietary preferences and restrictions section prevents you from recommending foods a client dislikes or cannot eat. Including food allergy fields alongside dietary preferences makes it clear that allergies are a safety matter, not just a preference.
What to do with intake form responses
- Review the form before the appointment and note any red flags or areas to explore further.
- Use health goals and goal descriptions to frame your recommendations in the client's own language.
- Flag any conditions or medications that require specialist referral or extra caution.
- Cross-reference dietary restrictions with your meal plan templates before the session.
- Store completed forms securely in line with your data protection obligations.
- Update the form annually or when a client reports significant health changes.
Frequently asked questions
What is a nutrition client intake form?
A nutrition client intake form is a document completed by new clients before their first consultation. It collects essential information including personal details, health and medical history, dietary restrictions and allergies, lifestyle factors, and nutrition goals. The form helps practitioners prepare personalised recommendations and saves time in the initial appointment.
What sections should a nutrition intake form include?
A comprehensive nutrition intake form should cover personal information, current body measurements, health goals, medical history and diagnosed conditions, current medications and supplements, dietary preferences and restrictions, food allergies, lifestyle factors such as exercise and sleep, and a snapshot of typical daily eating. The template on this page includes all of these sections.
Should I ask about medical history on my intake form?
Yes. Medical history is critical for safe and effective nutrition practice. Conditions such as diabetes, cardiovascular disease, coeliac disease, PCOS and kidney disease all require specific dietary approaches. Knowing about current medications is equally important, as many drugs affect nutrient absorption or interact with specific foods. Always advise clients to seek medical clearance before making significant dietary changes.
Is this intake form template suitable for personal trainers?
Yes. Personal trainers who provide nutrition guidance as part of their coaching can use this form. The template covers both fitness goals and dietary preferences, making it relevant for performance nutrition as well as health and weight management clients. Personal trainers working in areas outside their scope of practice should refer clients to a registered dietitian for clinical nutrition conditions.
How do I send this intake form to clients before their appointment?
Print the form and post it, or save it as a PDF and email it ahead of the consultation. Ask clients to complete and return it at least 24 hours before their appointment so you have time to review it. For a more streamlined approach, Foodzilla lets you send fully customisable digital intake forms that clients complete online and submit securely.
Can I customise this intake form for my practice?
This is a printable template you can adapt. Print it and annotate it with your practice name, logo, and any additional fields you need. For a fully customisable digital version, Foodzilla's client registration feature lets you tailor your intake forms and collect responses digitally.