---
title: Metabolic Syndrome Screening & Assessment Form Template | Paperform
description: Professional screening form for metabolic syndrome risk assessment with waist circumference, lipid panel, glucose levels, and lifestyle intervention enrollment. Fully customizable for healthcare providers.
url: "https://paperform.co/templates/metabolic-syndrome-screening-assessment-form"
type: static
generatedAt: "2026-03-28T00:44:31.415Z"
---

[← Back to free form templates](/templates/)    ![Metabolic Syndrome Screening & Assessment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/metabolic-syndrome-screening-assessment-form.png)
    [Preview](https://_preview.paperform.co/ai-template/metabolic-syndrome-screening-assessment-form) [Use this template for free](/create?ai-template=metabolic-syndrome-screening-assessment-form)    [Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/) [Physician](/templates/role/physician/)[Nurse](/templates/role/nurse/)[Healthcare Administrator](/templates/role/healthcare-admin/)     About this free form template
Metabolic syndrome affects millions of people worldwide and significantly increases the risk of heart disease, stroke, and type 2 diabetes. Early detection and intervention are critical for preventing serious health complications—and having a systematic, professional screening process in place is the first step.

This **Metabolic Syndrome Screening & Assessment Form** is designed for healthcare providers, wellness clinics, occupational health programs, and community health organizations that need to efficiently identify at-risk patients and guide them toward evidence-based interventions.

The form captures all five key diagnostic criteria for metabolic syndrome—waist circumference, blood pressure, fasting glucose, triglycerides, and HDL cholesterol—while also collecting important lifestyle and medical history information that helps clinicians understand each patient's complete risk profile.

Beyond screening, the template includes optional enrollment sections for lifestyle intervention programs, making it easy to transition patients directly from assessment to action. Whether you're running workplace wellness initiatives, preventive care clinics, or community health screenings, this form gives you a structured way to document findings and connect patients with the support they need.

Built with Paperform, the template is fully customizable to match your organization's protocols and branding. Use conditional logic to show relevant follow-up questions based on screening results, collect eSignatures for program consent using [Papersign](https://papersign.com), and integrate with your EHR or patient management system to keep records organized and accessible.

You can also connect this form to [Stepper](https://stepper.io) to automate follow-up workflows—send risk stratification alerts to your clinical team, schedule follow-up appointments automatically, or enroll patients in educational email sequences based on their screening outcomes.

Whether you're a family physician, nurse practitioner, corporate wellness coordinator, or public health professional, this form template helps you deliver high-quality metabolic syndrome screening with consistency, efficiency, and a patient-centered approach.
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