BMI & Body Composition Form
Asks about date of measurement, weight (lbs/kg), and height (in/cm). Built for routine obesity screening at annual primary care visits.
- Questions
- 10
- Page
- 1
- Time
- about 3 min
Your practice
BMI & Body Composition Form
Live preview. Tap through it like a patient.
Who it is for
- Routine obesity screening at annual primary care visits
- Weight management program intake and progress tracking
- Bariatric surgery pre-operative eligibility documentation
- Corporate wellness and employee health screening programs
What's inside
Before you publish: Clinical review required: this worksheet does not calculate scores, diagnose, or recommend treatment. Confirm the questions and response options against your approved assessment protocol before use.
- Patient NameText · Required
- Date of MeasurementDate
- Weight (lbs/kg)Number
- Height (in/cm)Number
- BMI recordingNumber
- BMI ClassificationLong Text
- Waist CircumferenceNumber
- Body Fat PercentageNumber
- Physical Activity LevelLong Text
- Provider NotesLong Text
From form to a ready patient

01
Make it yours
Reword, reorder, or add to the BMI & Body Composition Form, and add your logo.

02
Patients finish it at home
A secure link by text or email, filled out on their phone before the visit. No app.

03
Your team sees who is ready
Each visit shows as ready once its forms are in. Answers land on the patient record.
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Questions
Send it before the visit, so patients arrive ready.
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