Nutritional Counseling Consent & Dietary Assessment Form

Streamline Your Nutrition Practice with Professional Consent Forms

When you're running a nutrition practice, collecting detailed dietary information and proper consent shouldn't slow you down. This Nutritional Counseling Consent & Dietary Assessment Form is built specifically for registered dietitians, nutritionists, and wellness practitioners who need to gather comprehensive client information while ensuring legal compliance—all in one professional, easy-to-use form.

What This Template Includes

This form handles everything from HIPAA authorization and treatment consent to detailed dietary assessment and meal planning preferences. Your clients can share their health history, current medications, dietary restrictions, nutrition goals, and lifestyle factors in a clear, organized format. The form also collects physician information and collaboration authorization, making it simple to coordinate care when needed.

Perfect for Nutrition & Wellness Professionals

Whether you're offering one-on-one nutritional counseling, weight management programs, sports nutrition services, or specialized medical nutrition therapy, this template adapts to your practice. It's ideal for:

• Registered dietitians working in private practice or clinics
• Nutritionists offering virtual or in-person consultations
• Wellness coaches integrating nutrition into holistic health programs
• Functional medicine practitioners requiring detailed intake and consent
• Health coaches focusing on sustainable lifestyle changes

Why Choose Paperform for Your Nutrition Practice

With Paperform's doc-style editor, you can customize this template to match your brand and specific services in minutes—no coding required. Add your logo, adjust questions for your specialties (like sports nutrition, pediatric nutrition, or diabetes management), and set up conditional logic to show relevant follow-up questions based on client responses.

The form integrates seamlessly with your existing tools. Send completed assessments to your CRM, save them to Google Drive or Dropbox, or trigger workflows in Stepper to automatically send welcome emails, schedule follow-up appointments, or create client files in your practice management system.

Need clients to sign consent forms? Connect Papersign to turn submissions into legally binding eSignature documents, keeping consent forms and dietary assessments perfectly linked for your records.

Professional, Secure, and SOC 2 Compliant

Your clients trust you with sensitive health information, and you need forms that protect that data. Paperform is SOC 2 Type II compliant and offers robust security features, making it a reliable choice for healthcare professionals who need HIPAA-adjacent workflows (note: Paperform is not HIPAA compliant itself, but provides enterprise-grade security for many healthcare applications).

Stop juggling PDFs, email chains, and paper forms. This template gives you a single, professional intake experience that saves time, looks polished, and helps you deliver better nutritional care from the very first interaction.