What is the nutrition intake questionnaire form template?
Before a first nutrition consultation can be genuinely useful, you need a real picture of how someone actually eats — not just what they say they eat in the room. This template asks the questions that matter: diet type, allergies and their severity, medical conditions, daily habits, and what the client actually wants to achieve, all before you ever sit down together.
A paper intake form gets left in a bag, and an email thread means chasing details across three messages. An online questionnaire lets a client answer at their own pace, expands to ask for more detail only when it's relevant (a severe allergy triggers different follow-up than a mild one), and arrives complete and organised, ready to read before the appointment rather than during it.
Once submitted, FileIt saves the whole questionnaire as a PDF in the client's vault folder, alongside their food diary or blood test uploads if they've included any — everything you need for that first session, filed in one place before you even meet.
- Best for
- Nutritionists, dietitians and health coaches taking on a new client
- Filled in by
- The client, ahead of their first consultation
- Time to complete
- About 10-12 minutes
- Includes
- Allergy severity logic, a lifestyle habits grid, and optional file upload for food diaries or lab results
Who uses a nutrition intake questionnaire form?
- A registered nutritionist onboarding a new client before their first 1:1 session
- A gym or wellness studio adding a nutrition consultation to its personal training packages
- A health coach who wants a consistent intake questionnaire across every new client
- A dietitian working with clients managing a specific condition, such as diabetes or IBS, who need dietary changes
- A weight-management programme collecting baseline habits and goals before the first check-in
- A corporate wellness provider running short nutrition consultations for employees
Questions on this nutrition intake questionnaire form
27 questions over 4 pages · includes file upload, conditional questions, multiple pages, consent checkbox, ratings.
1 About you
- Full name*
- Email*
- Phone
- Date of birth
- Sex Female · Male · Intersex · Prefer not to say
- Height (cm)
- Weight (kg)
2 Diet & allergies
- Which best describes how you eat?* I eat everything · Mostly plant-based, some meat or fish · Pescatarian · Vegetarian · Vegan · Low-carb / keto
- Cultural or religious food requirements Halal · Kosher · No pork · No beef · Regular fasting periods
- Do you have any food allergies or intolerances?*
- Which ones?* asked only when it applies Peanuts · Tree nuts · Milk / dairy · Egg · Gluten / wheat · Soy · Fish · Shellfish · Sesame
- How severe is your most serious reaction?* asked only when it applies Mild discomfort · Moderate (hives, swelling, stomach upset) · Severe / anaphylaxis — I carry an adrenaline pen
- Medical conditions or medication affecting what you eat
- Supplements you take
3 Habits
- Meals per day 1–2 · 3 · 4 or more · It varies
- Water per day Less than 1 litre · 1–2 litres · More than 2 litres · Not sure
- How often do you… Rarely · Sometimes · Often · Daily
- Alcohol None · Occasionally · A few drinks a week · Most days
- Caffeinated drinks per day None · 1–2 · 3–4 · 5 or more
- Describe a typical day of eating
- Is there anything about food you find difficult?
4 Goals
- What would you like help with?* Lose weight · Gain weight / muscle · More energy · Sports performance · Digestion / gut health · Managing a health condition · Healthier everyday habits
- What would you like to be different in 3 months?
- How confident are you in the kitchen?
- Weekly food budget Tight — keep it cheap · Moderate · Flexible
- Food diary or recent blood test results
- Declaration*
The nutrition intake questionnaire form, page by page
1 About you
Basic contact and biometric details open the form: Full name, Email, Phone, Date of birth, an optional Sex field (used only to estimate energy needs), and optional Height and Weight fields. Everything biometric is clearly marked optional, so a client uncomfortable sharing numbers up front can still complete the rest of the form.
2 Diet & allergies
The client describes how they eat — omnivore, flexitarian, pescatarian, vegetarian, vegan or low-carb/keto — and flags any cultural or religious food requirements like halal, kosher or fasting periods. A yes/no for food allergies or intolerances opens up a checklist of common allergens (peanuts, tree nuts, dairy, gluten, shellfish and more) and, critically, a How severe is your most serious reaction? question ranging from mild discomfort to severe anaphylaxis with an adrenaline pen.
Medical conditions or medication affecting diet, and any supplements the client takes, are captured as open text — useful context a nutritionist needs before making any recommendations.
3 Habits
This page builds a realistic picture of everyday eating: Meals per day, Water per day, and a How often do you… grid covering things like eating breakfast, snacking, cooking from scratch and eating late at night, rated from rarely to daily. Alcohol and Caffeinated drinks per day are asked separately, and a Describe a typical day of eating field with a sample placeholder helps clients who aren't sure how to start.
An optional, clearly confidential question — Is there anything about food you find difficult? — gives clients space to mention cravings, emotional eating or a history of disordered eating without it being tucked awkwardly into another question.
4 Goals
Clients pick what they'd like help with (weight loss, weight gain or muscle, more energy, sports performance, gut health, managing a condition, or generally healthier habits) and describe What would you like to be different in 3 months?. A confidence-in-the-kitchen scale and a Weekly food budget question help tailor advice that's actually realistic for the client to follow.
An optional file upload lets clients attach a food diary or recent blood test results, and a short note reminds them that nutrition advice isn't a substitute for medical care before they sign a declaration confirming their answers are accurate.
Make the template yours
- Add your own intake questions specific to your specialism, such as sports nutrition or a particular medical condition you focus on
- Adjust the allergy checklist to include allergens more common in your region or client base
- Make height and weight required if your practice always needs them for baseline tracking
- Set a maximum file size expectation in your form instructions for clients uploading blood test PDFs
- File each response under the client's own vault folder so their intake, food diaries and later session notes stay together
- Turn on the emailed PDF copy so clients keep a record of exactly what they told you at intake
Tips for a better nutrition intake questionnaire form
- Reassure clients up front that there are no right or wrong answers — people under-report less when they don't feel judged
- Read the allergy severity answer before the appointment, not during it, especially for anything marked severe
- Ask about typical eating patterns in the client's own words as well as structured questions — the free-text "typical day" field often reveals more than the checkboxes
- Keep questions about disordered eating optional and clearly marked confidential, and follow up sensitively if something concerning comes up
- Revisit the goals section at each check-in, not just at intake — goals shift once someone starts seeing results
Every response becomes a PDF in your vault
Once a client submits their questionnaire, FileIt saves it as a PDF in the vault folder you've set up for them, along with any food diary or lab result files they attached. You get a notification straight away, and the client can receive their own PDF copy too if you've turned that setting on — useful so they have a record of what they told you before the first session.
Most nutritionists review the PDF ahead of the appointment rather than during it, using the allergy and medical condition answers to flag anything to discuss carefully, and the goals section to shape the plan for that first conversation. Because responses are searchable in the Responses table, it's also easy to pull up a client's original intake months later to compare against how their habits have changed.
- Start from this template. It opens in the FileIt Forms designer — change any question, add pages, set the rules for when questions appear.
- Share it. Turn on a public link, or send it to people by email, each with their own link. They don’t need a FileIt account.
- Get the answers as PDFs. Each response is saved as a PDF in the vault folder you choose, with uploaded files attached — and listed in a Responses table you can export to CSV.
Nutrition intake questionnaire form: frequently asked questions
Is this nutrition intake form template free?
Yes — it's one of the templates included in FileIt's Forms app on every account, including the free plan, and every question can be edited.
Does the client need a FileIt account to fill it in?
No. You send them a link by email or share it publicly, and they complete it without creating an account.
Do we get the completed questionnaire as a PDF?
Yes, automatically — every submission is saved as a PDF in your FileIt vault, with any uploaded files attached to it.
Can clients upload a food diary or blood test results?
Yes, there's a file upload field on the goals page specifically for a food diary or recent blood test results, accepting PDFs, images and common document formats.
Does the form ask about serious allergies?
Yes — if a client says they have an allergy, they're also asked how severe their most serious reaction is, up to and including whether they carry an adrenaline auto-injector.
Is this a substitute for medical advice?
No, and the form itself includes a note to that effect. Nutrition advice isn't medical care, and clients with a medical condition should keep their doctor informed of significant dietary changes.
Can we add questions specific to sports nutrition or a medical condition?
Yes, every field in the template can be edited, added to or removed in the designer to match your specific practice.
How is client data kept private?
Answers are encrypted at rest in FileIt, and only people with access to your vault can view submitted responses.