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💪 Fitness & Nutrition

Free Eating Habits Assessment Template

Assess meal regularity, food quality, hydration and mindful eating, then generate a personalized AI PDF report with practical next steps.

5 dimensions
~10 min
AI PDF Report
AI Consultant
Live Preview

Quick answer

Free and ready to use, the Eating Habits Assessment lets nutrition coaches assess eating habits in minutes. Responses to the Eating Habits Assessment are auto-scored across its 5 rated areas and turned into a printable AI PDF report you can share.

Disclaimer: this page and its AI report are for self-reflection and process reference only. They do not constitute medical, psychological, financial, legal or safety advice. Consult a qualified professional when needed.

Methodology: items are a structural adaptation of widely used frameworks, not an official version; scoring is indicative, not diagnostic.

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About this template

The Eating Habits Assessment helps nutrition coaches assess eating habits in a structured, repeatable way instead of guessing or rebuilding from scratch.

Each response is scored across all 5 rated areas — from the regularity of your meals to the overall quality of your food — and turned into a personalized, printable AI PDF report. A QR code on the Eating Habits Assessment report opens an AI consultant chat about those results, so the client gets clear next steps and you get a deliverable you can stand behind.

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Template at a Glance

Seven facts about the Eating Habits Assessment, in the order you will need them.

TemplateEating Habits Assessment
CategoryFitness & Nutrition
FormatEating-habits review, five areas rated 1–5
Time to completeAbout 10 minutes
What you getA weighted profile across regularity of your meals, overall quality of your food, daily fruit and vegetable intake and the remaining rated area, delivered as a personalized, printable AI PDF report with a QR code into an AI consultant chat
Best forNutrition coaches
CostFree to copy, customize and reuse on FormLM
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Live Preview

Live preview of the Eating Habits Assessment as respondents see it, plus the scored AI PDF report it generates.

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Fill it in to see how responses flow.
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Sample AI report with scoring visuals and recommendations, printable as a PDF.
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Scan the QR on the report to start an AI consultant chat.
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What's Included

Everything the Eating Habits Assessment ships with, before you customize it.

1

Structured, ready-to-use fields

The Eating Habits Assessment scores regularity of your meals first, then overall quality of your food and the remaining rated areas.

2

Weighted 1–5 scoring

The Eating Habits Assessment: all 5 rated areas are weighted into one profile instead of being averaged.

3

Personalized AI PDF report

One printable report per respondent, drafted from their own answers to the Eating Habits Assessment.

4

QR code to AI consultant chat

The Eating Habits Assessment keeps every rating attached to daily fruit and vegetable intake and the other four areas, so nothing has to be retyped later.

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How It Works

Four steps from a copy of the Eating Habits Assessment to work you can hand over.

1

Use This Template

Copy the Eating Habits Assessment with its 5 scored dimensions, report layout and branding into your FormLM workspace — free.

2

Customize

Tune the Eating Habits Assessment — the 5 dimensions, their weightings and the question wording — to how you assess nutrition coaches.

3

Share and collect

Send the link or QR code for the Eating Habits Assessment; each response lands in one timestamped list.

4

Review and act

Open the AI PDF report the Eating Habits Assessment generated for that respondent and send it to them.

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When to Use This Template

Three moments where the Eating Habits Assessment earns its place.

1

At the start of a program

Set the baseline with the Eating Habits Assessment so the eight-week review has something real to compare against.

2

When progress stalls

Re-run the Eating Habits Assessment to see which of the 5 rated areas is holding the result back.

3

As a standalone paid assessment

Hand a walk-in client the Eating Habits Assessment report — the assessment itself is the deliverable, printable and branded.

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Who Is This For

Who runs the Eating Habits Assessment, and what each of them does with the responses.

Individual practitioners

Run the Eating Habits Assessment the same way for every client instead of rebuilding the form each time.

Teams & agencies

Standardize how nutrition coaches capture and review eating habits across many clients.

Founders & freelancers

Hand clients a branded, reusable Eating Habits Assessment — set it up once and it keeps working between sessions.

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Key Features

What makes the Eating Habits Assessment a usable deliverable rather than a blank form.

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Sample Questions Inside

The questions respondents meet in the Eating Habits Assessment — scored, with a per-person AI PDF report.

  1. How would you rate the regularity of your meals? (1–5)
  2. How would you rate the overall quality of your food? (1–5)
  3. How would you rate your daily fruit and vegetable intake? (1–5)
  4. How would you rate your water intake? (1–5)
  5. How would you rate your mindful (non-emotional) eating? (1–5)
  6. Which eating habit do you most want to change? (open)
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Frequently Asked Questions

What is the Eating Habits Assessment template?
It is the Eating Habits Assessment, a free, ready-to-use assessment template that nutrition coaches can set up in minutes and customize to their own workflow.
Who is it for?
It is designed for nutrition coaches who need a structured, professional way to assess eating habits.
Is it free to use?
Yes. Use This Template copies the Eating Habits Assessment with its 5 scored dimensions and report layout into your FormLM workspace at no cost, then you customize and share it.
Does it generate a report?
Yes. Once the 5 dimensions of the Eating Habits Assessment are answered, it computes a weighted score and produces a printable AI PDF report for that respondent.
Is there an AI consultant?
Yes. The report from the Eating Habits Assessment carries a QR code that opens an AI consultant chat about those 5 dimensions, so follow-up questions get answered without you.
How many responses can I collect?
No per-template limit. Run the Eating Habits Assessment for every assessment round and review all responses in one sortable list.
Is the AI report editable?
Yes. The report drafted from Eating Habits Assessment responses can be revised — wording, structure and branding — before you send it.
Why teams choose FormLM?
Because the Eating Habits Assessment ends in a deliverable: responses are scored across 5 weighted dimensions, turned into a printable AI PDF report, and the report carries a QR code into an AI consultant chat.
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Methods & terminology behind this template

Likert scale: definition and points Weighted scoring Free radar chart generator

Use the Eating Habits Assessment today

Copy the Eating Habits Assessment into your workspace, adjust the fields to how nutrition coaches already work, and send the link — free to start.