Client Health & Goals Intake
Edit a client health & goals intake template for nutrition coaches. Review it online, then unlock licensed PDF, Word, and print tools after purchase.
For Nutrition Coaches · Intake Form · CA$5
Capture goals, eating patterns, health history, medications, activity, sleep, providers, and readiness.
Included editable fields
- Nutrition Coach
- Client / Customer / Authorized Party
- Coaching Location / Format
- Client Nutrition Goals
- Dietary Pattern
- Relevant Health Information
- Coaching Period
- Referral / Care Contacts
- Intake Date
- Service / Job Location
- Job / Service Type
- Scope / Purpose
- Client Instructions / Prior History
- Client Responsibilities
- Pre-Start Confirmations
- Known Risks & Disclosures
- Limitations & Exclusions
- Information Authorization / Acknowledgement
- Intake Checklist
- Follow-Up / Outcome
- Record Timestamp