BMI & Body Composition Form
Screening

BMI & Body Composition Form

1 page10 fieldsHIPAA-ready
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BMI & Body Composition Form

BMI & Body Composition Form

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Patient Name
Jane Martinez
Date of Measurement
03/15/1985
Weight (lbs/kg)
154 lbs
Height (in/cm)
5' 7"
BMI recording
0
BMI Classification
Select an option...
Waist Circumference
0
Body Fat Percentage
0
Physical Activity Level
Select an option...
Provider Notes
Enter details here...
Submit
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The BMI & Body Composition Form provides a streamlined tool for recording anthropometric measurements and calculating body mass index as part of routine health screening and weight management programs. It captures weight, height, BMI calculation with WHO classification category, waist circumference, hip circumference, waist-to-hip ratio, and optional body fat percentage measurements. These combined metrics offer a more complete picture of body composition than BMI alone.

The form is designed for serial tracking, making it easy to document measurements across multiple visits and observe trends over time. It includes fields for recording patient weight goals, current physical activity levels, and relevant comorbidities associated with elevated BMI such as hypertension, type 2 diabetes, and obstructive sleep apnea. A notes section allows providers to document counseling provided and referrals to dietitians or weight management programs.

Used across primary care practices, endocrinology clinics, bariatric surgery programs, wellness centers, and corporate health programs, this form supports obesity screening as recommended by the USPSTF. It is also appropriate for pediatric growth monitoring when combined with age- and sex-specific BMI percentile charts, and for pre-surgical clearance documentation where BMI thresholds affect eligibility.

What's included

  • Weight and height measurement with BMI clinician-completed calculation
  • WHO BMI classification (underweight, normal, overweight, obese)
  • Waist circumference and waist-to-hip ratio fields
  • Body fat percentage and body composition tracking
  • Physical activity level and weight goal documentation
  • Comorbidity association and counseling documentation

Who uses this template

  • 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

All form fields

10 fields across 1 page. Customize any field after signing up.

Patient NameText
Date of MeasurementDate
Weight (lbs/kg)Number
Height (in/cm)Number
BMI recordingNumber
BMI ClassificationDropdown
Waist CircumferenceNumber
Body Fat PercentageNumber
Physical Activity LevelDropdown
Provider NotesLong Text

How to use the BMI & Body Composition Form

Getting started with this template takes just a few minutes. Sign up for a free Formisoft trial, then select the BMI & Body Composition Form from the template library. The form is ready to use immediately, but you can customize every field, add your practice logo, and adjust the layout to match your workflow.

Setup steps

  1. 1Choose the template. Find the BMI & Body Composition Form in the template library and click “Use this template” to add it to your account.
  2. 2Customize fields. Add, remove, or reorder any of the 10 fields. Set fields as required or optional based on your practice needs.
  3. 3Brand it. Upload your logo, pick your colors, and add a custom welcome message so patients see your practice identity.
  4. 4Share with patients. Send the form via SMS, email, or embed it on your website. Patients complete it on any device before their visit.
  5. 5Review submissions. Responses appear in your dashboard in real time. Patient records are created automatically from the data collected.

Frequently asked questions

Is the BMI & Body Composition Form HIPAA compliant?

Yes. All Formisoft templates, including the BMI & Body Composition Form, are HIPAA compliant. Data is encrypted with 256-bit AES at rest and TLS 1.3 in transit. A Business Associate Agreement (BAA) is included on every plan.

Can I customize the fields in this template?

Absolutely. You can add, remove, reorder, or modify any of the 10 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

How do patients fill out this form?

Patients receive a link via SMS, email, or QR code. They complete the form on their phone, tablet, or computer before their appointment. No app download required.

Can I send this form automatically before appointments?

Yes. Formisoft's workflow automation can send intake forms automatically when an appointment is booked. You can set the timing (e.g., 48 hours before the visit) and include reminders for patients who haven't completed it.

Does this template work on mobile devices?

Yes. The BMI & Body Composition Form is fully responsive and works on any device. Most patients complete intake forms on their phone, so every template is optimized for mobile-first use.

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