Do you need a new client intake form that is a better fit for your anti-diet approach? Then look no further!

This is the only form you’ll need to collect information from a prospective nutrition client.

It will definitely set you apart from your competitors with an intake form that streamlines the intake process and asks questions in a weight that is weight-inclusive and trauma-informed.

With both PDF and Canva template formats included, you can customize them with your colors and logo and then seamlessly integrate them onto your website or social media page in just minutes!

  • PDF download
  • Canva Pro template – Customizable for your branding
  • Canva Pro template is editable if you need to make any changes to the information requested
  • 8-page intake form that looks modern and professional
  • Includes the following sections:
    • Personal information
    • Emergency contacts
    • Lifestyle information
    • Family history
    • Personal health history
    • Weight history/fluctuation history
    • Food and exercise behavior history
    • Hospitalization/surgery history
    • Medications
    • Supplements
    • Allergies
    • Diet
    • Diet recall

PLEASE NOTE: YOU WILL NEED A CANVA PRO SUBSCRIPTION FOR SOME OF THE PHOTOS AND FONTS

Please email me with any questions or concerns at [email protected] I will be happy to help you!

INSTANT DOWNLOAD: Once you purchase this item, it will be available for instant download from RD2RD.

LICENSE: You may not share, sell, or distribute the file.

Copyright 2021 © Vickery Wellness, LLC. Vickery Wellness, LLC retains all rights to the design and file.

Because this is a digital file, no refunds will be made.

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