About this template
A Nutrition and General Health Questionnaire is an essential tool for dietitians, nutritionists, personal trainers, and wellness coaches who need a structured way to evaluate client progress and lifestyle changes. Whether you are running follow-up assessments or conducting re-tests, this form captures critical data on dietary adjustments, supplement adherence, sleep patterns, and stress levels.
By gathering comprehensive updates before consultations, health professionals can spend less time reviewing paperwork and more time delivering personalized coaching and actionable advice. This template covers everything from recent health milestones and lifestyle modifications to targeted feedback on supplements and overall wellness.
With Doc2Form, you can instantly turn this structured assessment into a ready-to-use Google Form, making it effortless to collect mobile-friendly responses from clients on any device. Streamline your practice workflow, track client milestones accurately, and maintain a clear historical record of nutritional progress over time.
Key features
- Capture detailed updates on diet, sleep, and exercise habits.
- Track supplement adherence and gather product feedback.
- Identify new health concerns or shifting wellness goals.
- Collect client testimonials and referral notes seamlessly.
- Fully mobile-friendly for easy completion on any smartphone or tablet.
Use cases
- Follow-up nutritional consultations and client re-assessments.
- Tracking progress in multi-week fitness and wellness coaching packages.
- Gathering baseline health metrics before creating custom meal plans.
What this form collects
- Date (Date)Select today's date for this progress check-in.
- Full Name (Short answer)Enter your first and last name.
- Biggest Changes So Far (Paragraph)What are the most notable physical or lifestyle changes you've experienced since our last session?
- Health Concerns to Focus On (Paragraph)List any new or ongoing health concerns you would like to prioritize moving forward.
- Diet Changes Since Last Assessment (Paragraph)Describe any adjustments you have made to your daily food intake, meal timing, or portion sizes.
- Lifestyle Changes: Sleep, Exercise, and Stress (Paragraph)Share how your sleep quality, physical activity levels, and daily stress management have evolved recently.
- Supplement Adherence (Multiple choice)How consistently have you been taking your recommended supplements?
- Supplement Feedback (Paragraph)Have you noticed any positive effects or side effects from your current supplement routine?
- Likelihood to Recommend (Linear scale)How likely are you to recommend our coaching services to a friend or colleague?
- Additional Feedback (Paragraph)Is there anything else you would like your practitioner to know before your upcoming session?
- Testimonial (Paragraph)If you are comfortable sharing your success, please write a brief testimonial about your experience working with us.
- Friend or Family Referral Note (Paragraph)If you would like to refer someone who might benefit from our services, please share their name and contact details here.
FAQ
How does Doc2Form help me use this template?
Doc2Form instantly converts this structured questionnaire into a fully functioning Google Form in your Google Drive, ready to send to clients immediately.
Can I edit the questions after generating the form?
Yes! Because the form lives directly in your Google account, you have complete freedom to add, remove, or modify any questions using the standard Google Forms editor.
Is this questionnaire suitable for follow-up sessions?
Yes, this template is specifically designed for re-tests and check-ins to monitor dietary changes, supplement adherence, and lifestyle adjustments over time.
Can clients fill out this form on their mobile phones?
Absolutely. Google Forms are fully responsive and work smoothly on smartphones, tablets, and desktop computers.
How do I share the form with my clients?
You can share the Google Form via a direct link, email invitation, or by embedding it directly on your practice website.
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.