Get Nutritional Intake Forms

Filling out the Nutritional Intake Forms online is an essential step in obtaining personalized nutritional counseling. This guide will provide you with clear, step-by-step instructions to complete the form effectively, ensuring that your information is accurately conveyed to the counselor.

Follow the steps to successfully complete the Nutritional Intake Forms online.

1. Press the ‘Get Form’ button to access the nutritional intake form and open it in the online editor.
2. Begin by filling in your name and student ID at the top of the form. This information helps identify you and your case.
3. Enter your birth date, phone number, and email address. This contact information is crucial for communication and appointment reminders.
4. Specify your age, marital status, and sex. This demographic information assists the counselor in understanding your background.
5. Indicate whether the counselor may leave a message or email you. Make your preferences clear by selecting 'Yes' or 'No'.
6. Provide a brief reason for seeking nutritional counseling and list any specific questions that you would like answered during your appointment.
7. Outline your past medical history, including any current medication or nutritional supplements you might be taking. This information is vital for your personalized counseling.
8. Describe your living situation by checking the appropriate boxes, such as living on campus or with a partner. Include details about household members with whom you share groceries.
9. Record your sleep patterns by noting the average number of hours you sleep on weekdays and weekends.
10. List any family medical history relevant to dietary concerns, including conditions like diabetes or obesity.
11. Specify any food allergies, intolerances, or dietary preferences you may have.
12. Input your highest, current, and lowest weight along with your height. Additionally, describe any recent weight changes.
13. Express how you perceive your current weight using the provided scale and indicate your level of satisfaction with your weight.
14. If weight is a specific concern, respond to the supplementary questions regarding dieting thoughts and feelings about food.
15. Describe your eating habits and any past attempts to change your diet, including methods used and results experienced.
16. Provide information regarding smoking and alcohol use, exercise habits, and whether you use the Rec Center at your location.
17. If applicable, answer questions specific to women regarding menstrual cycles and pregnancy.
18. Finally, review all entries for accuracy. Once complete, you can save your changes, download the form, print it, or share it with your counselor.

Start completing your Nutritional Intake Forms online today to begin your journey towards better health.