Healthy Living Survey Templates

As a personal trainer, nutritionist, life coach, or other medical professional helping people build happier, healthier lives, you need to know what your clients are up to when they’re not in your office—so you can help them make positive changes. In fact, one-third of healthcare professionals who use SurveyMonkey’s healthcare surveys say they’re monitoring their clients’ health habits.

How to create health, nutrition, and lifestyle surveys

Health, nutrition, and lifestyle surveys are a great tool for pinpointing where your clients and patients need the most help. What goals are they trying to achieve, and what challenges do they struggle with? You may want to know their food and exercise habits and whether or not they smoke. Together, using the feedback from our expert-certified healthcare questionnaires, you and your clients can make key mind-body connections.

You can also use online healthcare polls to get your clients’ feedback on your services and support— information that can help you give your clients what they need to succeed. And use patient monitoring and tracking surveys to discover pertinent medical information about patients, while making patient intake and organizing their information much easier.

Ways to use surveys in client coaching

Use surveys at the outset of your client engagements, and ongoing, as a way to gauge their progress towards goals. During and after your engagements, ask for their feedback to find out how you’re doing and to identify opportunities for improving your services.

Client goals and challenges

Use surveys to build your clients’ positive self-perception even as you’re gathering background information. Learn about your clients’ goals and attitudes, as well as the attempts they’ve made in the past and why they believe they were successful or not. What other programs or approaches have they tried to stop smoking, for example, and how long did they end up not smoking? Ask about past challenges they faced and overcame—and have them describe what they believe made them successful.

Lifestyle and habits

Establish a baseline prior to beginning an exercise, nutrition, or behavior modification program with your new clients. Use surveys to find out about height and weight, diet and exercise, health and nutrition, and smoking habits. See if your client is attempting to change their habits during a period of stress at work or at home, and use this insight to help them prepare good coping strategies.

Client satisfaction

Are you meeting your goal of helping your clients? If you’re not seeing the results you expected, ask your clients for feedback. Are clients concerned about how healthcare reform will affect them? Are they happy with your services and the way in which you’re working with them? Use surveys to obtain both structured and unstructured feedback that can help you improve what you’re doing and help your clients succeed. CAHPS and HCAHPS surveys were created just for this purpose to allow doctors and hospitals to obtain feedback, but any professional can use these templates.

Marketing

How did your clients hear about you? Why did they choose you, your group practice, your gym, or your class over others in their community? Use surveys to figure out what strategies are most effective for client programs and education, as well as to ask for referrals and testimonials. Share surveys on social media to discover new ways to engage your clients.

Sample Healthy Living Survey Templates

Use one of our sample surveys as is or customized. Or build your own survey! Get started with our best practices on creating good survey questions, or use our Question Bank of methodologist-certified questions.

Height and Weight

Use this survey to gather height and weight data as a baseline and ongoing at regular intervals.

Do You Have Health Insurance?

Check with your clients about their insurance coverage and the types of health and wellness services covered. Your clients may find that their providers cover some of your services, too.

You in 12 Months.

Are your clients experiencing the stress of a major life transition? Use this survey to identify the current or potential stresses that may be influencing your clients and their food, exercise, and behavioral habits.

Endurance Event Feedback.

Does your gym or organization sponsor an endurance event as the culmination of a special training or fitness program? Survey your clients after the event to find out what they thought of it—and whether they would participate in this kind of activity again in the future.

Instructor Feedback.

Customize this template to survey class participants after you’ve delivered a special fitness course or lifestyle education program. Find out if your attendees found the information valuable, and what they thought of the instructor and delivery.

Need to comply with HIPAA?

SurveyMonkey supports surveys that collect protected health information! If you’re a covered entity regulated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and want to collect protected health information in your health and well-being surveys, please see our HIPAA Compliance at SurveyMonkey page for more details.

Diet and Exercise Template

Track your clients’ and patients’ diet and exercise habits. Find out if they’re eating a balanced diet and if they feel they get enough physical activity.

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Personal Hygiene Template

This survey helps you ask your clients or patients about their self-care habits, including how often they bathe and if they’re practicing dental hygiene.

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Smoking Template

Use this survey to understand your clients’ or patients’ smoking habits or see if they’re being exposed to second-hand smoke.

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3 quick tips to improve survey response rates

Here are some ideas to ensure that respondents will answer your surveys.

1. Be quick

If your survey is short and sweet, there's a greater chance that more respondents will complete it.

2. Offer incentives

Little incentives like small discount or an entry into a drawing can help ensure respondents complete your survey.

3. Buy a targeted audience

With SurveyMonkey Audience, you can purchase access to an audience who meets specific demographic criteria for your survey. It's a great way to get targeted responses from a specific group.

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