Prefer it online? Patients fill it out on their phone before the visit.
Practice name: ______________________________
BMI & Body Composition Form
Patient Name *
Date of Measurement
____ / ____ / ________
Weight (lbs/kg)
Height (in/cm)
BMI recording
BMI Classification
Waist Circumference
Body Fat Percentage
Physical Activity Level
Provider Notes
BMI & Body Composition Form template from formisoft.com. formisoft.com/intake-templates/bmi-calculator