About this template
The Health and Wellness Evaluation Form is designed for health coaches, fitness professionals, and wellness consultants who need a structured way to assess their clients' physical and mental well-being. This template systematically captures essential baseline data—including dietary habits, exercise frequency, and personal health objectives—giving you the insights required to build effective, personalized wellness plans.
Whether you manage a handful of private coaching clients or run a wellness practice, this form streamlines your intake process and eliminates messy paperwork. Clients can easily detail their daily routines, current fitness levels, and specific goals from any device. With Doc2Form, you can instantly turn this layout into a live Google Form, making it effortless to collect, organize, and review client data in one centralized spreadsheet.
Key features
- Assess client nutrition habits and daily meal routines in detail.
- Capture primary health goals and measure commitment levels.
- Track exercise frequency and current physical activity.
- Fully mobile-optimized for clients completing forms on the go.
- Instantly sync all responses directly to Google Sheets.
Use cases
- Initial intake consultations for new health coaching clients.
- Quarterly wellness progress tracking for ongoing fitness programs.
- Pre-assessment questionnaires for corporate wellness challenges.
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 evaluation summary?
- Phone Number (Short answer)Include your country and area code if applicable.
- Breakfast Status (Multiple choice)Do you regularly eat breakfast?
- 3 Meals Per Day Status (Multiple choice)How consistently do you eat three balanced meals daily?
- Sport or Exercise Frequency (Dropdown)How often do you engage in intentional physical activity or exercise?
- Primary Health Goal (Paragraph)What is your main focus for working with a wellness coach?
- Goal Seriousness Level (Linear scale)On a scale of 1 to 5, how committed are you to making lifestyle changes right now?
- Overall Well-Being Rating (Linear scale)How would you rate your current overall physical and mental well-being?
- Additional Notes or Message (Paragraph)Share any injuries, dietary restrictions, or extra details you want your coach to know.
FAQ
How do I share this form with my clients?
Once Doc2Form converts your template into a Google Form, you can easily share it via a direct link, email it to clients, or embed it directly on your website.
Can I customize the questions on this form?
Yes! Because the template lives in your Google Drive as a standard Google Form, you can add, remove, or modify any questions to match your specific coaching methodology.
Is this form mobile-friendly for my clients?
Google Forms are fully responsive by default, allowing your clients to complete their wellness evaluations smoothly from their smartphones, tablets, or computers.
Where is the client data stored?
All form submissions are securely stored in your personal Google Drive and automatically populated into a linked Google Sheets spreadsheet for easy review.
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.