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Nutrition Assessment Form

Get instant client nutrition assessments, capturing their current diet, habits, and satisfaction in one quick form.

Description

The Nutrition Assessment Form gives coaches a fast way to understand a new client’s eating at a glance. It captures how they describe their current diet, what they consume regularly, and a typical day of eating, so you get a clear snapshot to start from.

Fields for any food allergies and how satisfied they are with their current habits round out the picture, while name and email keep each assessment organized. Capturing the essentials quickly means you can begin offering relevant, useful advice from the very first conversation, long before a full intake.

A quick assessment sharpens every consultation. Sign up for a free Fun Forms account to customize the fields and embed this assessment on your website.

Form fields

Everything the Nutrition Assessment Form above collects — 9 fields, so you can see exactly what it captures before you make it your own.

Nutrition Check-In

  • How would you describe your current diet?

    Single-Select Icon
    Single-Select
  • Please specify:

    Short Answer Icon
    Short Answer
  • Which of these do you consume regularly?

    Multi-Select Icon
    Multi-Select
  • Describe a typical day of eating for you

    Long Answer Icon
    Long Answer
  • Do you have any food allergies?

    Yes/No Icon
    Yes/No
  • Please list allergies:

    Short Answer Icon
    Short Answer
  • How satisfied are you with your current eating habits?

    Scale Icon
    Scale
  • Name

    Name Icon
    Name
  • Email address

    Email Icon
    Email
Use Template Arrow Right Icon

Template FAQs

Common questions about the Nutrition Assessment Form — what it captures, when to use it, and how to make it your own.

What is a nutrition assessment form?

A nutrition assessment form is an online form that captures a client’s current eating at a glance. It records their diet, regular foods, and satisfaction, so a coach gets a quick, clear snapshot to begin offering relevant advice from the first conversation.

Why ask how satisfied a client is with their habits?

Asking how satisfied a client is reveals their readiness to change and where they feel they struggle. Someone unhappy with their habits is often motivated to act, so understanding this helps you focus support where the client most wants it and gauge how ready they are.

Why ask for a typical day of eating?

A typical day of eating shows real habits far better than general descriptions. It reveals patterns, gaps, and opportunities at a glance, giving you concrete detail to work with rather than vague impressions, so your advice is grounded in how the client actually eats.

Why capture food allergies?

Capturing any food allergies from the start ensures any advice you give is safe and appropriate. It prevents recommending foods a client cannot eat and shows you are taking their needs seriously, which builds trust from the very first assessment.

How does a quick assessment help?

A quick assessment gives you a useful snapshot of a client’s eating without a lengthy intake, so you can offer relevant advice immediately. It is ideal for a first touchpoint, helping you understand each client fast and decide how best to support them going forward.

Is the nutrition assessment form free?

Yes, this nutrition assessment form is completely free, and you can customize the fields to fit your coaching, embed it on your website, and go live with no coding required. Just create a free Fun Forms account to start assessing clients online.