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Wellness · free template

Nutrition Coaching Questionnaire

Food history, habits, medical flags and goals: the intake behind a safe nutrition plan.

A ready-to-use fitness, wellness & coaching form for clinics, coaches and therapists: 17 questions, 2 pages, 3 conditional rules.

Questions
17
Pages
2
Layouts
classic · card
Conditional rules
3
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Live preview and test console

This is the real form. Answer it to test the 3 conditional rules — nothing is sent or stored.

Page 1 of 2 — Now

Every question on this page is currently visible.

Compliance checklist

Ready to publish
  • Payment items priced — passingEvery payment question charges a real amount, so a submission always records a payment.
  • Conditional logic resolves — passingEvery rule points at a question or page that exists in this template.
  • Medical disclaimer present — passingThis form does not provide medical advice, diagnosis or treatment. Information you share here is not a substitute for care from a qualified clinician. In an emergency, contact your local emergency service immediately.
  • Question labels unique — passingLogic and exports address questions by label, so duplicates are ambiguous.

What happens after submit: nothing is stored in this preview. On your own copy, every response triggers an instant email notification and lands in your response dashboard, ready to export or forward.

Happy with it? Take a copy into your workspace — every question, rule and setting comes with it.

Who this template is for

Nutrition Coaching Questionnaire 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 17 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.

  • 6 questions are required, so submissions arrive complete instead of needing a follow-up email.
  • It collects a verified email address so replies and confirmations land.
  • It accepts a document or photo upload as evidence.
  • It captures a numeric value you can filter and sort on.
  • 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.

  1. 1Press “Use this template” — a fresh copy of Nutrition Coaching Questionnaire lands in your workspace, ready to edit.
  2. 2Rename or delete any question, and change what is required. Nothing here is fixed.
  3. 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.
  4. 4Check the upload limits on the file question so respondents can attach what you actually need.
  5. 5Publish 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.
  6. 6Watch 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 advanced show logic: if “Medical conditions and medications” is answered, the form dynamically exposes “GP clearance note”. Otherwise that question never appears.
  • Features advanced show logic: if “Medical conditions and medications” is answered, the form dynamically exposes “Clearance or notes upload”. Otherwise that question never appears.
  • Features advanced show logic: if “Ready to track food?” is No, the form dynamically exposes “Photo diary alternative note”. Otherwise that question never appears.
  • All 3 rules are editable in the Logic tab, and the built-in checker warns about rules that contradict each other.

About this template

A nutrition plan built without a proper history is a guess dressed up as advice, so this questionnaire spends its first page on what is actually happening now rather than what the client wishes were happening. Describing a typical day of eating in their own words reveals more than any tick-box list of food groups, and questions about meals eaten out, water and alcohol fill in the gaps that self-reported diaries usually miss. The second page turns to history and risk: allergies, medical conditions and medications are asked directly rather than folded into a general health question, because a missed interaction between a supplement recommendation and existing medication is the kind of mistake this form exists to prevent. Naming that condition triggers a request for GP clearance and an upload field, keeping the paper trail attached to the plan rather than a separate email nobody can find later. Diets tried before help avoid recommending something that has already failed, and a plain question about willingness to track food determines whether the plan leans on logging or on a simpler photo diary instead.

What this form asks

Every question is editable — rename it, make it optional, or delete it entirely.

Page 1 — Now

  • Full namerequired
  • Email addressrequired
  • Age
  • Height and weight
  • Typical day of eatingrequired
  • Meals out per week
  • Water intake
  • Alcohol

Page 2 — History & goals

  • Allergies and intolerancesrequired
  • Medical conditions and medications
  • GP clearance note
  • Clearance or notes upload
  • Diets tried before
  • Primary goalrequired
  • Cooking skill and time
  • Ready to track food?required
  • Photo diary alternative note

17 questions in total.

How the form changes as it's filled in

This template ships with 3 conditional rules, grouped into 2 behaviours driven by 2 questions. Everything below is already set up — edit or delete any rule once the template is in your workspace.

Driven by “Medical conditions and medications”

  • Reveals questions

    If “Medical conditions and medications” is answered, the form reveals “GP clearance note” and “Clearance or notes upload”.

Driven by “Ready to track food?”

  • Reveals questions

    If “Ready to track food?” is No, the form reveals “Photo diary alternative note”.

Set it up step by step

  1. 1

    Read the typical day answer before anything else

    It usually shows the real pattern that the goal and diet-history answers only hint at.

  2. 2

    Chase clearance before recommending supplements

    Any disclosed medical condition should have a GP note on file before the plan is finalised.

  3. 3

    Match the tracking method to the answer given

    Forcing an app on someone who said no to tracking is the fastest way to lose them in week two.

  4. 4

    Cross-check diets tried before you write the plan

    Avoid repeating an approach the client has already told you failed.

Mistakes to avoid

  • Writing a plan before a disclosed medical condition has been cleared by a GP.
  • Ignoring the stated cooking skill and time, then handing over recipes nobody will actually cook.
  • Treating alcohol and meals-out questions as optional extras rather than the habits that most often derail a plan.

What it pairs with

Most teams don't run this form on its own. These are the forms and systems it sits next to.

What to do with the responses

Wait for GP clearance where flagged, then build the plan around the stated cooking time, tracking preference and primary goal.

Works in both layouts

Browse classic templatesBrowse card templates

Forms that overlap this one

These pages cover the same subject ground as the nutrition coaching questionnaire, matched on the words people actually search for.

Privacy & compliance

This form collects health information. Keep access limited to the people who need it, turn on encrypted answers for the clinical questions, and set a retention window so records don't sit in the dashboard forever.

Frequently asked questions

Do I need to be a registered dietitian to use this?

Coaches can use it for general nutrition guidance, but medical conditions flagged here should route to a qualified professional.

How detailed should the typical day answer be?

Encourage clients to write it as they'd tell a friend, including snacks and drinks, not just planned meals.

What if someone refuses to log food at all?

The photo diary alternative keeps some visibility without demanding the tracking they've already declined.

Should this be repeated periodically?

Re-run the history questions every few months, since medications and conditions can change between plans.

Is the Nutrition Coaching Questionnaire template free to use?

Yes. You can preview and test Nutrition Coaching Questionnaire 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 Nutrition Coaching Questionnaire template ask for?

It asks 17 questions across 2 pages, 6 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 Nutrition Coaching Questionnaire 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 advanced show logic: if “Medical conditions and medications” is answered, the form dynamically exposes “GP clearance note”. Otherwise that question never appears. Features advanced show logic: if “Medical conditions and medications” is answered, the form dynamically exposes “Clearance or notes upload”. Otherwise that question never appears. Features advanced show logic: if “Ready to track food?” is No, the form dynamically exposes “Photo diary alternative note”. Otherwise that question never appears. All rules are editable in the Logic tab.

Where do responses to the Nutrition Coaching Questionnaire 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 Nutrition Coaching Questionnaire 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.

Can respondents upload files?

Yes. This template includes a file upload question, so respondents can attach documents or photos with their answers. You can adjust the accepted file types and size limits on that question.

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