Wellbeing Screening Form — shared by the community
Priya N. shared this 9-question build with 3 conditional rules already wired up. Test it below, then take a copy.
A ready-to-use fitness, wellness & coaching form for clinics, coaches and therapists: 9 questions, 2 pages, 3 conditional rules.
- Shared by
- Priya N. · Operations lead
- Questions
- 9
- Replies
- 11
- Copies taken
- 80
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Live preview and test console
This is the real form. Answer it to test the 2 conditional rules — nothing is sent or stored.
Page 1 of 2 — Quick check-in
Every question on this page is currently visible.
Works for you? Take Priya N.'s copy into your own workspace — questions, rules and settings included.
Who this template is for
Wellbeing Screening Form is built for clinics, coaches and therapists who need to collect intake detail and consent before the first session.
- Clinics, coaches and therapists working in fitness, wellness & coaching.
- Teams who need to collect intake detail and consent before the first session without writing code or paying for a custom build.
- Anyone replacing paperwork eating the start of every appointment with one structured record per enquiry.
- Respondents are clients and patients — the form asks them 9 questions across 2 screens.
- Mobile-heavy audiences, thanks to the one-question-per-screen card layout.
Why this form is useful
It removes the cost of paperwork eating the start of every appointment and turns each submission into a record your team can act on immediately.
- 2 questions are required, so submissions arrive complete instead of needing a follow-up email.
- It measures sentiment on a numeric scale.
- Conditional logic hides 3 questions until they are relevant — shorter forms convert better than long ones.
- Splitting the form across 2 pages keeps each screen short and shows respondents how much is left.
- Every response is stored, searchable and exportable, so nothing depends on one person's inbox.
How to use this template
From copy to live form is a few minutes of work, and every step is reversible.
- 1Press “Use this template” — a fresh copy of Wellbeing Screening Form lands in your workspace, ready to edit.
- 2Rename or delete any question, and change what is required. Nothing here is fixed.
- 3Open Notifications and add the email addresses that should be alerted on each submission; add an auto-reply to the respondent if the form collects an email address.
- 4Publish it, then either share the link directly or paste the embed snippet into your site — the embedded form resizes to fit and loads no marketing or advertising trackers.
- 5Watch responses land in Submissions, where you can filter, label and export them to CSV or PDF.
Logic and conditions blueprint
Exactly how this form behaves as it is answered — 3 conditional rules ship with it.
- Features conditional validation: if “Would you like someone to follow up with you?” is Yes, please reach out, “Best way to reach you” becomes mandatory before the form can be sent.
- Features conditional hiding: if “Would you like someone to follow up with you?” is No thanks, just checking in, “Best way to reach you” is removed from the form and is never submitted.
- Features conditional hiding: if “Would you prefer to answer anonymously?” is Yes, keep this anonymous, “Name (optional)” is removed from the form and is never submitted.
- All 3 rules are editable in the Logic tab, and the built-in checker warns about rules that contradict each other.
What this form asks
Page 1 — Quick check-in
- Would you prefer to answer anonymously?required
- Name (optional)
- How would you rate your mood lately?
- How manageable does your stress feel right now?
- How has your sleep been recently?
- Do you feel you have people to turn to if needed?
Page 2 — Anything else
- Anything you'd like to share? (optional)
- Would you like someone to follow up with you?required
- Best way to reach you
Conditional logic in this build
- When “Would you like someone to follow up with you?” is Yes, please reach out, require “Best way to reach you”.
- When “Would you like someone to follow up with you?” is No thanks, just checking in, hide “Best way to reach you”.
- When “Would you prefer to answer anonymously?” is Yes, keep this anonymous, hide “Name (optional)”.
Questions about this shared form
Does this diagnose a mental health condition?
No — it's an informal check-in with no diagnostic or clinical claims. Anyone needing assessment or treatment should be pointed to a qualified professional, such as through the Therapy Intake Form.
How is this different from the Therapy Intake Form?
This screening is a quick, often anonymous pulse-check used before someone has decided to seek therapy. The Therapy Intake Form is the fuller onboarding paperwork completed once a client has booked a session.
Is this suitable for a workplace setting?
Yes, many HR and wellbeing teams use a short check-in like this alongside the Employee Wellbeing Survey, which covers broader workplace satisfaction rather than personal wellbeing.
What if someone reports being in crisis?
This form should never be the only channel for urgent support — always display crisis-line or emergency-service information prominently, as shown in the opening text.
Is the Wellbeing Screening Form template free to use?
Yes. You can preview and test Wellbeing Screening Form on this page without an account, and take a copy into your own HelloForms workspace on the free plan. There is nothing to install and no card required to publish it.
What does the Wellbeing Screening Form template ask for?
It asks 9 questions across 2 pages, 2 of which are required. Every question is listed in full further down this page, and each one can be renamed, reordered, made optional or deleted after you copy the template.
Can I edit the Wellbeing Screening Form form after copying it?
Yes — the copy is entirely yours. Change wording, add or remove questions, switch between the classic and card layouts, restyle it to match your brand, and set who gets notified on each submission.
How does the conditional logic in this fitness, wellness & coaching form work?
3 conditional rules ship with the template: Features conditional validation: if “Would you like someone to follow up with you?” is Yes, please reach out, “Best way to reach you” becomes mandatory before the form can be sent. Features conditional hiding: if “Would you like someone to follow up with you?” is No thanks, just checking in, “Best way to reach you” is removed from the form and is never submitted. Features conditional hiding: if “Would you prefer to answer anonymously?” is Yes, keep this anonymous, “Name (optional)” is removed from the form and is never submitted. All rules are editable in the Logic tab.
Where do responses to the Wellbeing Screening Form form go?
Submissions land in your workspace under Submissions, where you can search, filter, label and export them to CSV or PDF. You can also email a notification to your team on every submission and send the respondent an auto-reply.
Can I embed the Wellbeing Screening Form form on my own website?
Yes. Publish the form and paste the embed snippet into any page or share the direct link. The embedded form resizes to fit its container and loads no advertising or marketing trackers inside the iframe.
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