About this template
A wellness intake form is an essential tool for health practitioners, wellness coaches, clinic owners, and fitness specialists to gather crucial background information before a first appointment. This comprehensive questionnaire helps you understand your clients' current health status, lifestyle habits, specific wellness challenges, and personal goals.
By collecting these insights in advance, you can tailor your sessions or treatment plans to meet each client's unique needs from day one. Doc2Form makes it effortless to deploy this template, allowing you to share a clean, professional link with clients so they can submit their details securely from any mobile device or desktop before stepping through your door.
Key features
- Collect complete personal and contact details in one step
- Understand client wellness goals and specific health challenges
- Fully customizable questions to match your practice's specific needs
- Optimized for seamless completion on mobile devices and desktops
- Instantly save and organize all responses in Google Sheets
Use cases
Initial consultations at holistic health and wellness clinics
New client onboarding for personal trainers and nutrition coaches
Pre-treatment evaluations at specialized spas and beauty salons
Intake assessments for massage therapists and physical wellness pract…
Intake assessments for massage therapists and physical wellness practitioners
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Email Address (Short answer)Where can we reach you with appointment updates and resources?
- Phone Number (Short answer)Include your area code.
- Date of Birth (Date)Format: MM/DD/YYYY
- Gender (Dropdown)Select the option that best describes you.
- How did you hear about us? (Dropdown)Let us know how you found our practice.
- Primary Wellness Focus (Checkboxes)Select the main areas or issues you would like to address during our sessions.
- Issue Details (Paragraph)Please provide more details regarding the wellness concerns or symptoms you selected above.
- Used Our Products in the Last 6 Months? (Multiple choice)Let us know if you have used any of our proprietary products recently.
- Used Other Treatments in the Last 6 Months? (Multiple choice)Have you tried any outside treatments or therapies for your current concerns?
- Interested in Before/After Volunteer Programs? (Multiple choice)Would you be open to sharing your progress as a case study or volunteer?
- Mailing List Opt-In (Multiple choice)Would you like to receive wellness tips, updates, and special offers via email?
FAQ
How do I share this wellness intake form with my clients?
Once you convert and save the template to your Google Drive, you can easily share it via a direct link, email it to booked clients, or embed it directly on your practice website.
Can I add or modify questions on this template?
Yes! Because it is a native Google Form, you have full control to add, edit, or reorder any questions using the standard Google Forms editor.
Where are client responses stored?
All submissions are automatically routed to your connected Google Sheet, making it simple to review client histories and manage your intake records in one secure place.
Is this wellness intake form mobile-friendly?
Yes, Google Forms automatically adapts to smartphones, tablets, and computers, ensuring your clients can complete their paperwork smoothly from any device.
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.