The intake form is the least glamorous document in your practice and the one that does the most work. It tells you who you are dealing with before the first call. It catches the things you are not allowed to touch. And it is the first place a client sees whether you are a professional or a hobbyist.
What the form is for
Three jobs, in order:
- Safety. Find out whether this person needs a doctor or a dietitian before they need you.
- Fit. Learn what they actually want, so the first session is useful instead of an interview.
- Record. Create the baseline you will measure against, and the paper trail that protects both of you.
If a question on the form does not serve one of those three, cut it. Long forms get abandoned.
Section by section
1. Contact and basics
Name, email, phone, date of birth, how they prefer to be contacted, and who referred them. Age matters because your approach with a teenager, a pregnant client, or an older adult is different, and some of those may need a referral before you start.
2. Health history
This is the safety section. Ask directly:
- Any diagnosed medical conditions, past or present
- Current medications and supplements, with doses if they know them
- Allergies and intolerances
- Pregnancy or breastfeeding, now or planned
- Recent surgery, hospital stays, or unexplained weight change
- Any history of an eating disorder or disordered eating
- Whether they are currently under the care of a physician or dietitian for anything food-related
You are not collecting this to treat it. You are collecting it so you know what you cannot treat. A “yes” on a diagnosed condition or an eating disorder history means the first conversation is about coordinating with their medical team, not about meal timing.
3. Food and routine
What a normal weekday looks like from waking to bed. When they eat, where, with whom, who cooks, who shops. What they eat on a good day and on a bad day. Skip the exhaustive food-frequency questionnaire. A plain description of yesterday tells you more.
4. Movement, sleep, stress
Three or four questions each. Not to diagnose anything, but because these shape what is realistic. A client sleeping five hours and working two jobs does not need a plan built for someone with a free afternoon.
5. Goals, in their words
Leave a big empty box. “What do you want to be different in three months?” and “What have you tried before, and what happened?” The second question saves you from recommending the thing that already failed twice.
6. Consent and scope
This is the part most people copy from someone else and never read. Write yours. It should say, in plain language:
- What you are: a certified nutritionist providing general nutrition education and coaching
- What you are not: a physician or a registered dietitian, and not a substitute for either
- That you do not diagnose, treat, or prescribe, and do not advise on medication
- That you will refer out when something is outside your scope, and that they agree to follow up with their own providers
- How you store their information, who can see it, and how long you keep it
- Your cancellation and payment terms
Then a signature and a date. If the form is digital, a typed name with a checkbox and a timestamp.
What to leave off
- Anything that sounds like a medical screening you will act on. If you are not going to do something clinical with a lab value, do not ask for it.
- Weight as a required field. Ask whether they want to track it. For some clients it is useful. For others it is the reason they avoided help for years.
- Questions you ask because a template had them. Every field costs you a little trust and a little completion rate.
How to use it once it is filled in
Read it before the session, not during. Mark three things:
- Anything that needs a referral or a medical sign-off first. Raise it at the start of the call, plainly.
- The one thing they said they want most. Build the session around it.
- The one thing they already tried that did not work. Do not recommend it again.
Then keep the form. It is your baseline. When a client says nothing has changed in two months, the intake usually shows otherwise.
Digital or paper
Digital wins for almost everyone. Clients finish a form on their phone the evening they book, you get it before the call, and the timestamp on the consent box is automatic. If you use a form tool, make sure the answers land somewhere private and that the tool lets you export and delete a client’s data when they ask. Paper is fine for an in-person practice, as long as it goes into a locked drawer and gets scanned the same week.
Storage and access
An intake form contains health information, and people trust you with it. Keep it somewhere that requires a login, not in an email thread or an open shared folder. Decide how long you keep records after a client leaves and write that down in your consent. Do not let a client’s health history sit on a laptop that also runs your kids’ games.
The short version
Contact, health history, routine, goals in their words, and a consent section you actually wrote. Cut anything that does not serve safety, fit, or the record. Read it before the session. Store it like it matters, because it does.
Questions people ask
What should be on a nutrition client intake form?
Contact details, a health history that captures diagnosed conditions, medications, allergies, pregnancy, and any eating disorder history, a description of a normal day of eating, brief questions on sleep, movement, and stress, the client's goals in their own words, and a consent section that states your scope and how you handle their information.
Do nutritionists need an informed consent form?
Yes. A consent section should say plainly what you are, what you are not, that you do not diagnose, treat, or advise on medication, that you will refer out when needed, how you store information, and your payment and cancellation terms. Have the client sign and date it before the first session.
Should a nutritionist ask about medications on an intake form?
Yes, so you know what is present, not so you can advise on it. Any question about starting, stopping, or adjusting medication goes back to the prescriber. Knowing the list helps you recognize when a client needs that conversation.
Should I ask for weight on a nutrition intake form?
Make it optional and ask whether the client wants to track it. Weight is useful for some clients and a barrier for others. A required weight field can stop someone from finishing the form at all.
How long should a nutrition coach keep client records?
Decide a retention period, state it in your consent, and follow it. Store records somewhere that requires a login rather than in email or an open shared folder. Check whether your state has record-keeping rules that apply to you.
This article is general educational information, not medical, dietetic, or legal advice, and is not a substitute for care from a licensed physician or registered dietitian. Certifications offered on this site are private credentials, not a government license and not the Registered Dietitian (RD/RDN) credential. Nutrition practice is regulated differently in each state; confirm what you are permitted to do in your state before practicing.