Introduction & Onboarding
Done For You Resources
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As an INE student, you have permission to use the resources on this page for your professional use with your clients.
You are welcome to distribute the materials on this page “as is” (with the existing footers) or personalize them as long as you put ONE of the following acknowledgments on each page in the footer:
- Distributed by your name with permission.
© Dr. Ritamarie Loscalzo, MS, DC, CCN, DACBN, Institute of Nutritional Endocrinology (INE) www.DrRitamarie.com - Adapted by your name with permission.
© Dr. Ritamarie Loscalzo, MS, DC, CCN, DACBN, Institute of Nutritional Endocrinology (INE) www.DrRitamarie.com
This page contains templates for all of the history taking tools presented in this module. When you’re first starting out, you can save time by using these forms as is and giving them to your clients to complete. As time goes on, you will probably want to create some of your own forms, using questions from these as guides. Feel free to rephrase things to reflect your own voice and the need of your specific clientele.
There are several good forms creation tools – some paid and some free. Experiment with a couple of forms to find the one you like most, and start to develop your own. Google Forms is free.
Magic Questions
PDFs
NOTE: These can be used and given to clients as is.
General History Taking Form Templates
- Mastering the Nutritionally Oriented Client History
- Strategy Session Intake Form
- History Taking – General Information
- Family Health History Assessment
- Health and Habits “Get to Know You” Questionnaire
- Dental History Assessment
- Past Health History Assessment
- Adrenal Assessment: Physical Symptoms
- Bodily Functions Assessment
- Ready and Willing Assessment
Scorecard Assessments
- Adrenal Assessment
- Body Systems and Organs Assessment
- Body Systems Assessment
- Bone Health Assessment
- Brain and Neurotransmitter Assessment Scorecard
- Candida and Gut “Dysbiosis” Assessment
- Cardio and Respiratory Health Assessment
- Detox Capacity Assessment
- Digestive Function Assessment Scorecard
- Food Allergy Detection Assessment
- Genetic Factors Assessment Scorecard
- Hormones and Glands Assessment Scorecard
- Immune System Assessments
- Insulin Resistance Assessment
- Leaky Gut Assessment Scorecard
- Nutrient Balance: General Assessment
- Nutrient Balance: Mineral Assessment
- Nutrient Balance: Vitamin Assessment
- Oxidation Status Assessment Scorecard
- Reproductive Hormone Assessment – Female
- Reproductive Hormone Assessment – Male
- Thyroid Assessment
- Toxicity Assessment
Tracking Forms
- Blood Pressure and Pulse Tracker
- Bowel Transit Time Tracker
- Diet Diary, Supplements, and Medication Tracker
- Diet Diary
- Medication Tracker
- pH Tracking: Saliva and Urine
- Supplement Tracker
- Thyroid Temperature Monitoring Chart
Google Docs
NOTE: These can be customized with your logo and information, make sure to use disclaimer at the top of this page.
General History Taking Form Templates
- Mastering the Nutritionally Oriented Client History
- Strategy Session Intake Form
- History Taking – General Information
- Family Health History Assessment
- Health and Habits “Get to Know You” Questionnaire
- Dental History Assessment
- Past Health History Assessment
- Adrenal Assessment: Physical Symptoms
- Bodily Functions Assessment
- Ready and Willing Assessment
- Private Coaching Pre-Call Form (Google Form) – Note: Use this as a template to create your own form to have your clients complete before each session.
Scorecard Assessments
- Adrenal Assessment
- Body Systems and Organs Assessment
- Body Systems Assessment
- Bone Health Assessment
- Brain and Neurotransmitter Assessment Scorecard
- Candida and Gut “Dysbiosis” Assessment
- Cardio and Respiratory Health Assessment
- Detox Capacity Assessment
- Digestive Function Assessment Scorecard
- Food Allergy Detection Assessment
- Genetic Factors Assessment Scorecard
- Hormones and Glands Assessment Scorecard
- Immune System Assessments
- Insulin Resistance Assessment
- Leaky Gut Assessment Scorecard
- Nutrient Balance: General Assessment
- Nutrient Balance: Mineral Assessment
- Nutrient Balance: Vitamin Assessment
- Oxidation Status Assessment Scorecard
- Reproductive Hormone Assessment – Female
- Reproductive Hormone Assessment – Male
- Thyroid Assessment
- Toxicity Assessment
Tracking Forms
- Blood Pressure and Pulse Tracker
- Bowel Transit Time Tracker
- Diet Diary, Supplements, and Medication Tracker (Google Sheet)
- Diet Diary (Google Sheet)
- Medication Tracker (Google Sheet)
- pH Tracking: Saliva and Urine
- Supplement Tracker (Google Sheet)
- Thyroid Temperature Monitoring Chart (Google Sheet)
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