Forms in Healthie's Specialty Library

Graduates of many leading coaching academies, nutrition schools, and accreditation services use this platform to run their businesses upon program completion. 

If you are a graduate of an affiliate program of Healthie, the platform has common intake forms of these groups, which enables you to automatically leverage these forms into your account. 

Please review the directory of forms available below. If you a part of a graduate program, but do not see your program listed, please message us, as this directory is ever-evolving. 

If you would like to request that these forms be added to your account, please message our live support. Proof of your affiliation with a specific group may be requested. 

Integrative and Functional Nutrition Academy ( IFNA)

  • IFNA Long Form 
  • IFNA Short Form 
  • IFNA Hands On 
  • IFNA Dietary Assessment 
  • IFNA MSQ

Institute of Functional Medicine ( IFM)

  • IFM MSQ 
  • IFM Female Intake 
  • IFM Male Intake 
  • IFM 3-day journal 
  • IFM Self-care 
  • IFM Thyroid 
  • IFM Sleep 
  • IFM Toxin Exposure 
  • IFM Depression / Anxiety 
  • IFM Exercise / Diet Nutrition 1 Day journal 
  • IFM Practicing Gratitude  
  • IFM Goal Setting for Behavior Change 
  • IFM 1 day / 3 day / 7 day journal 
  • IFM Daily Activity Questionnaire 

Functional Medicine Coaching Academy (FMCA)

  • MSQ (Medical Symptoms Questionnaire)
  • PERMA (Positive, Emotion, Engagement, Relationships, Meaning, Accomplishment)
  • PROMISE 10 (Patient-Reported Outcomes Measurement Information System)
  • Environmental Exposure History Form
  • Metabolic
  • Life Stress

Functional Diagnostic Nutrition

  • Metabolic Chaos Scorecard Part 1: 88907
  • Metabolic Chaos Scorecard Part 2: 88908
  • Medical History: 88909
  • Terms of Service

Institute for Integrative Nutrition (IIN) 

  • Men's Health History 
  • Women's Health History 

LEAP Food Sensitivities 

  • Symptom Survey 
  • Pre-assessment 
  • MRT 

Charting templates available (sample):

Sports assessment
Diabetes initial and follow up
ADIME
SMART goal summary

If you do not see a form that you would like added to your Healthie account, please message our live support - we have the ability to create custom intake forms & charting templates.