About this template
A comprehensive Health & Lifestyle Questionnaire is an essential tool for health coaches, personal trainers, wellness advisors, and clinical researchers. This structured assessment helps you gather vital baseline data regarding a client's daily nutrition, physical activity levels, personal wellness goals, and existing health concerns before beginning a new program or consultation.
Designed to streamline client onboarding, this Google Form template ensures you capture all necessary health metrics and lifestyle habits accurately and securely. By collecting this information upfront, you can tailor your recommendations, personalize fitness and diet plans, and track client progress over time more effectively.
With Doc2Form, you can deploy this questionnaire in seconds. Simply copy the template directly into your Google Drive, customize the questions to fit your specific coaching framework, and share the link with clients via email or your website to start collecting structured wellness data immediately.
Key features
- Capture complete dietary habits and activity levels in one organized form.
- Assess energy levels and weight goals to build customized wellness plans.
- Identify underlying health concerns or restrictions before starting training.
- Built seamlessly on Google Forms for effortless sharing and data management.
Use cases
Initial client intake for personal trainers and private nutritionists.
Baseline wellness assessments for corporate health and wellness progr…
Baseline wellness assessments for corporate health and wellness programs.
Lifestyle data collection for clinical research studies and health su…
Lifestyle data collection for clinical research studies and health surveys.
Pre-consultation screening for holistic health coaches and lifestyle …
Pre-consultation screening for holistic health coaches and lifestyle advisors.
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Email Address (Short answer)Where can we reach you with your results and recommendations?
- Phone Number (Short answer)Enter your best contact number for appointment reminders.
- Balanced Nutrition Status (Multiple choice)How would you describe your current daily nutritional intake?
- Energy Level Rating (Linear scale)Rate your average daily energy level throughout the day.
- Weight Goal (Multiple choice)What is your primary objective regarding your body weight?
- Target Weight Change Amount (Short answer)If applicable, how many pounds/kilograms would you like to gain or lose?
- Exercise Frequency Rating (Multiple choice)How many days per week do you engage in intentional physical exercise?
- Health Concerns (Paragraph)List any medical conditions, injuries, physical limitations, or allergies we should be aware of.
- Phone Contact Permission Status (Multiple choice)Do you give us permission to contact you via phone call or text regarding your wellness program?
FAQ
How do I use this health questionnaire template?
Simply click the Doc2Form link to instantly copy this template directly into your Google Drive account. You can then edit, add, or remove questions to suit your specific coaching methodology.
Can I customize the questions to match my coaching program?
Yes! Because it is a native Google Form, you have complete control to modify existing questions, add your own branding, or include specific queries tailored to your services.
How do clients access and submit the form?
You can share the form via a direct link, email it to clients before their first session, or embed it directly on your website. Responses are automatically saved to a connected Google Sheet for easy review.
Is this template free to use?
Yes, this template is completely free to copy, customize, and use with your clients or respondents.
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.