About this template
This Health & Lifestyle Questionnaire Google Form template is designed for wellness coaches, personal trainers, and health consultants looking to streamline client intake and capture qualified leads. The form covers essential wellness metrics, including daily nutrition status, energy levels, physical activity frequency, and specific health or weight goals. By gathering these insights upfront, you can understand your prospects' starting points and tailor your recommendations effectively.
Beyond basic contact details like name, email, and phone number, the questionnaire includes targeted inquiries about lifestyle habits and program interests. Whether you are offering nutrition coaching, personal training packages, or specialized fitness challenges, this template provides a structured way to segment leads and follow up with the right offers. Using Doc2Form, you can instantly deploy this questionnaire as a Google Form and start collecting responses immediately.
Key features
- Assess client nutrition, energy, and fitness levels instantly.
- Capture contact details and preferred communication channels like WhatsApp.
- Identify specific health goals and weight management targets.
- Gauge interest in specialized wellness challenges and remote coaching.
- Fully customizable to match your brand and service offerings.
Use cases
- Initial consultations for personal trainers and nutritionists.
- Lead generation campaigns for wellness bootcamps and health challenges.
- Client onboarding for online fitness and lifestyle coaching programs.
- Health risk and habit assessments for gym memberships.
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Email Address (Short answer)Where should we send your consultation details and recommendations?
- Phone Number (Short answer)Include your country code if outside your local region.
- WhatsApp Number (Short answer)Provide your WhatsApp number if you prefer messaging over phone calls.
- Balanced Nutrition Status (Multiple choice)How would you rate your current daily nutrition and eating habits?
- Energy Level Rating (Multiple choice)Select the option that best reflects your typical daily energy levels.
- Weight Goal (Multiple choice)What is your primary physical or weight objective?
- Weight Change Amount (Short answer)Roughly how many kilograms or pounds are you looking to gain or lose?
- Exercise Frequency (Dropdown)How many days per week do you currently engage in intentional physical exercise?
- Primary Health Concerns (Paragraph)Describe any specific health concerns, past injuries, or physical limitations we should know about.
- Interest in Healthy Breakfast Offers (Multiple choice)Would you be interested in trying our recommended healthy breakfast starter pack?
- Challenge Call Interest Status (Multiple choice)Would you like to join our upcoming 21-day wellness challenge and schedule a quick intro call?
- Work-from-Home Interest Status (Multiple choice)Are you interested in learning about flexible home-based wellness coaching opportunities?
FAQ
How do I customize this health questionnaire for my coaching business?
Once you convert the template into a Google Form using Doc2Form, you can easily edit, add, or remove questions directly in Google Forms to match your specific program offerings.
Can I collect phone numbers and WhatsApp details?
Yes, the template includes dedicated fields for phone numbers and WhatsApp numbers so you can reach out to prospects through their preferred communication channel.
Is this template suitable for online wellness coaches?
Absolutely. It includes questions tailored for remote clients, work-from-home habits, and virtual challenge interest.
How quickly can I start collecting responses?
Doc2Form converts this template into your Google Drive in seconds, allowing you to share the live form link with prospects immediately.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.