---
title: Nutrition Counseling Agreement Form Template | Paperform
description: Professional nutrition counseling agreement form with dietary assessment, meal planning, insurance coverage, payment terms, and cancellation policy. Perfect for dietitians and nutritionists.
url: "https://paperform.co/templates/nutrition-counseling-agreement"
type: static
generatedAt: "2026-03-28T00:44:39.748Z"
---

[← Back to free form templates](/templates/)    ![Nutrition Counseling Agreement](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/nutrition-counseling-agreement.png)
    [Preview](https://_preview.paperform.co/ai-template/nutrition-counseling-agreement) [Use this template for free](/create?ai-template=nutrition-counseling-agreement)    [Healthcare & Medical Forms](/templates/category/healthcare/)[Legal & Compliance Forms](/templates/category/legal/) [Coaching](/templates/industry/coaching/)[Healthcare](/templates/industry/healthcare/)[Fitness & Wellness](/templates/industry/fitness-wellness/) [Health Coach](/templates/role/health-coach/)[Healthcare Administrator](/templates/role/healthcare-admin/)[Dietitian](/templates/role/dietitian/)[Nutritionist](/templates/role/nutritionist/)     About this free form template
### Streamline Your Nutrition Practice with a Professional Counseling Agreement

Running a successful nutrition counseling practice requires more than just expertise in diet and wellness—it demands clear communication, proper documentation, and efficient client onboarding. This **Nutrition Counseling Agreement template** is designed specifically for dietitians, nutritionists, and wellness coaches who want to establish professional relationships with clients while covering all the essential legal and operational details.

#### Why Your Nutrition Practice Needs a Digital Agreement Form

Traditional paper agreements create unnecessary friction in the client onboarding process. Clients have to print, sign, scan, and email documents back—or worse, bring them to their first appointment, eating into valuable consultation time. With Paperform's nutrition counseling agreement template, you can:

 - **Onboard clients faster** with forms that can be completed on any device, anytime
 - **Collect dietary assessments** alongside agreement signatures in one seamless flow
 - **Automatically process payments** for initial consultations or program fees
 - **Maintain professional records** with all client information organized in one place
 - **Reduce no-shows** by clearly communicating cancellation policies upfront

#### What's Included in This Nutrition Counseling Agreement

This template covers everything you need to establish a clear, professional relationship with nutrition clients:

**Client Information & Contact Details**: Capture comprehensive client data including emergency contacts, which is essential for healthcare providers.

**Dietary Assessment & Health History**: Gather detailed information about current eating habits, dietary restrictions, allergies, health conditions, and nutrition goals—all before the first session, so you can hit the ground running.

**Service Selection & Meal Planning Preferences**: Let clients choose from different counseling packages (initial consultation, ongoing support, meal planning services) and indicate their dietary preferences, cooking skill level, and lifestyle factors that affect meal planning.

**Insurance Coverage Information**: Collect insurance details if you accept coverage, including policy numbers and primary care physician information for potential referrals or coordination of care.

**Follow-Up Schedule & Commitment**: Establish expectations for follow-up sessions, check-ins, and client responsibilities between appointments.

**Payment Terms & Fees**: Clearly outline your fee structure, accepted payment methods, late payment policies, and any package pricing—with optional integrated payment collection through Stripe, PayPal, or Square.

**Cancellation & Rescheduling Policy**: Protect your time and business by documenting your cancellation notice requirements, no-show fees, and rescheduling procedures.

**Professional Scope & Disclaimers**: Set appropriate boundaries by clarifying the scope of nutrition counseling services, noting that you're not providing medical diagnosis or treatment, and including necessary liability protections.

**Agreement & Consent**: Collect client acknowledgment and electronic signature on all terms, creating a legally sound agreement.

#### How Nutrition Professionals Use This Template

**Registered Dietitians** use this form to onboard new clients for medical nutrition therapy, gathering health history and insurance information while establishing clear professional boundaries between nutrition counseling and medical diagnosis.

**Holistic Nutritionists & Health Coaches** customize the form to reflect their coaching philosophy, add questions about lifestyle factors, stress levels, and wellness goals, and use it to set expectations for a collaborative coaching relationship.

**Sports Nutritionists** adapt the template to include questions about training schedules, performance goals, supplement use, and body composition objectives, while collecting waivers specific to athletic populations.

**Private Practice Owners** integrate the form directly into their website, allowing prospective clients to complete intake paperwork before the first appointment, dramatically reducing administrative time and improving the first-session experience.

**Wellness Centers & Integrative Clinics** use the form as part of a broader intake process, connecting it via Stepper to their practice management software, CRM, and calendar systems to create a seamless onboarding workflow.

#### Automate Your Nutrition Practice Workflow

Once you've collected a completed nutrition counseling agreement, the real power comes from automation. With **Stepper** (stepper.io), Paperform's AI-native workflow builder, you can:

 - Automatically send confirmation emails with pre-appointment instructions and food diary templates
 - Add clients to your nutrition practice management software or CRM
 - Schedule follow-up appointments directly in your calendar system
 - Trigger different email sequences based on the service package selected
 - Send the completed agreement to **Papersign** (papersign.com) if you need additional signature workflows or want clients to receive a fully executed copy with your signature as well
 - Update your accounting software with payment and billing information
 - Set reminders for client check-ins based on their follow-up schedule

This level of automation means you can focus on what you do best—helping clients achieve their nutrition and wellness goals—while the administrative details take care of themselves.

#### Compliance, Security & Professional Standards

When handling client health information, security and compliance matter. Paperform is **SOC 2 Type II compliant and GDPR compliant**, ensuring client data is protected with enterprise-grade security. While Paperform is not HIPAA compliant, it's suitable for general nutrition counseling practices that don't require HIPAA-level protections for protected health information (PHI).

All client agreements and dietary assessments are securely stored, easily searchable, and accessible whenever you need to review client history or prepare for follow-up sessions. You can also export data to maintain your own records or integrate with practice management systems.

#### Designed for Your Brand, Your Practice

This template is fully customizable to match your nutrition practice brand. Adjust the colors, fonts, and layout to reflect your professional identity. Add your logo, include photos of healthy meals or your counseling space, and write your policies in your own voice. The form can be embedded directly on your website or shared as a standalone link.

Whether you're a newly certified nutritionist launching your first private practice or an established dietitian looking to modernize your client onboarding process, this Nutrition Counseling Agreement template provides a professional, efficient, and client-friendly foundation for your practice.

#### Get Started in Minutes

This template is ready to use out of the box, but flexible enough to adapt to your unique practice needs. Simply customize the questions, add your specific policies and fee structures, connect your payment processor, and share with clients. Most nutrition professionals have their personalized version up and running in under 30 minutes.

Start building stronger, clearer client relationships from the very first interaction with a professional nutrition counseling agreement that works as hard as you do.
       Built for growing businesses, trusted by bigger ones.   Trusted by 500K+ business owners and creators, and hundreds of millions of respondents.     ![Capterra - 4.8 out of 5](/images/capterra-st.jpg)
 ![Trustpilot - 4.8 out of 5](/images/trustpilot-st.jpg)
 ![G2 - 4.8 out of 5](/images/g2-st.jpg)
  [Try Paperform free now](/register)
## More templates like this
  [![Argentine Nutritionist Meal Planning Services Contract](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/argentine-nutritionist-meal-planning-services-contract.png)

### Argentine Nutritionist Meal Planning Services Contract

Professional service agreement for nutritionist meal planning services in Argentina, including AFIP compliance, consultation frequency, and recipe customization preferences.](/templates/argentine-nutritionist-meal-planning-services-contract/)
[![Virtual Weight Management Program Enrollment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/virtual-weight-management-program-enrollment-form.png)

### Virtual Weight Management Program Enrollment Form

A comprehensive telehealth enrollment form for virtual weight management programs featuring BMI calculation, dietary assessment, exercise evaluation, and progress photo uploads.](/templates/virtual-weight-management-program-enrollment-form/)
[![Ayurvedic Treatment Emergency Contact Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/ayurvedic-treatment-emergency-contact-form.png)

### Ayurvedic Treatment Emergency Contact Form

Comprehensive emergency contact and health information form for Ayurvedic treatment centers, including dosha assessment, Panchakarma eligibility screening, herbal medicine interactions, and detox protocol consent.](/templates/ayurvedic-treatment-emergency-contact-form/)
[![Clinical Nutrition Consultation Intake Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/clinical-nutrition-consultation-intake-form.png)

### Clinical Nutrition Consultation Intake Form

A comprehensive intake form for clinical nutrition consultations that captures patient information, dietary history, food allergies, medical conditions, and nutrition therapy goals.](/templates/clinical-nutrition-consultation-intake-form/)
[![IV Vitamin Therapy Informed Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/iv-vitamin-therapy-informed-consent-form.png)

### IV Vitamin Therapy Informed Consent Form

Professional informed consent form for IV vitamin therapy services. Collect patient information, medical history, ingredient acknowledgment, and signed consent for vitamin infusion treatments.](/templates/iv-vitamin-therapy-informed-consent-form/)
[![Medical Weight Loss Program Age Verification & Health Assessment](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/medical-weight-loss-program-age-verification-health-assessment.png)

### Medical Weight Loss Program Age Verification & Health Assessment

A comprehensive age verification and health screening form for medical weight loss programs, including BMI calculation, health history assessment, and medication consent.](/templates/medical-weight-loss-program-age-verification-health-assessment/)
[![Medical Weight Management Telemedicine Enrollment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/medical-weight-management-telemedicine-enrollment-form.png)

### Medical Weight Management Telemedicine Enrollment Form

A comprehensive intake form for new patients enrolling in virtual weight management programs, including medical history screening, lifestyle assessment, virtual visit preferences, and coaching package selection.](/templates/medical-weight-management-telemedicine-enrollment-form/)
[![Nutritional Counseling Consent & Dietary Assessment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/nutritional-counseling-consent-dietary-assessment-form.png)

### Nutritional Counseling Consent & Dietary Assessment Form

A comprehensive nutritional counseling consent form with dietary assessment, meal planning preferences, supplement recommendations, and physician collaboration authorization for dietitians and nutritionists.](/templates/nutritional-counseling-consent-dietary-assessment-form/)
[![Prediabetes Screening & Prevention Program Enrollment](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/prediabetes-screening-prevention-program-enrollment.png)

### Prediabetes Screening & Prevention Program Enrollment

Comprehensive prediabetes screening form to assess glucose levels, lifestyle factors, and enroll in diabetes prevention programs including nutrition counseling and education classes.](/templates/prediabetes-screening-prevention-program-enrollment/)
[![Colon Hydrotherapy Emergency Contact & Health Screening Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/colon-hydrotherapy-emergency-contact-health-screening-form.png)

### Colon Hydrotherapy Emergency Contact & Health Screening Form

A comprehensive health screening and emergency contact form for colon hydrotherapy clients, including bowel disease history, surgical history, pregnancy status, and risk acknowledgment.](/templates/colon-hydrotherapy-emergency-contact-health-screening-form/)
[![Cryotherapy Treatment Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/cryotherapy-treatment-consent-form.png)

### Cryotherapy Treatment Consent Form

A comprehensive consent form for cryotherapy treatments that includes medical screening, temperature exposure risks, cardiovascular considerations, and session duration acknowledgment.](/templates/cryotherapy-treatment-consent-form/)
[![Holistic Nutrition Certification Scholarship Application](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/holistic-nutrition-certification-scholarship-application.png)

### Holistic Nutrition Certification Scholarship Application

Apply for a scholarship to pursue holistic nutrition certification with a focus on wellness coaching, whole foods philosophy, and functional medicine approaches.](/templates/holistic-nutrition-certification-scholarship-application/)