What Forms Do I Need For My Private Practice?

A common question we receive from new private practice owners is, “What Forms Do I Need For My Private Practice?

Although it may seem overwhelming to create the perfect intake forms or charting templates, we’ve taken a lot of the guess work out of it. We don’t want paperwork to stand in your way of launching your practice!

Here, we’re breaking down the important forms required for comprehensive client care. Plus, we’re giving you expert tips on how you can streamline the client form completion process.

These are the forms you should consider for your private practice:


Getting Started

  • Basic Information: Collect client information like name and address, phone numbers, emergency contacts, and more.
  • Nutrition Assessment Form: A basic nutrition assessment form collects general nutrition information. For example, your client’s reasons to visit with you, their nutrition goals, and nutrition history. This form can be as detailed as you like. Over the years we’ve learned, no 2 intake forms are the same!
    • Some providers have their clients fill out an intake form in advance of their first appointment, while others prefer to complete this form with their client.
    • Ask us about Healthie’s Smart Form available for Healthie community members to use in their practice.
  • HIPAA Privacy Notice: Protecting your client’s private health information is critical. This is why we recommend you have a HIPAA Privacy Notice. This form details how you protect their information and assures clients that you won’t share their information without their explicit approval.
    • You can download our sample HIPAA Privacy Notice here.
  • Charting Templates: ADIME, SOAP notes, or free-text notes are all acceptable charting methods. Charting helps you document your nutrition care plan.
    • FYI – ADIME and SOAP notes are a part of the dietitian Nutrition Care Process, and provide an organized format to Assess, Diagnose, Intervene, Monitor, and Evaluate your clients for ongoing care.

Office Policies

  • Cancellation Policy: Establishing a cancellation policy isn’t fun. For many health and wellness providers, however, it’s important. We’ve seen a variety of cancellation policies. Some practitioners charge a small fee for cancellations within 24 hours, while others request the full appointment fee. Whichever way you decide is most appropriate for your practice, be sure to have this discussion with your client early on in your relationship.
    • You can download our sample cancellation policy here.
  • Statement of Financial Responsibility: It’s important to secure a method of payment from every client. Having a client sign this statement ensures they are responsible for paying for services rendered.

For Referrals

  • PCP Referral Form: Insurance companies often require a referral from a primary care physician as part of your treatment. If this is the case, having the client’s primary care physician (PCP) complete your referral form can streamline the reimbursement process.
  • Information Release Authentication: An information release form details the individuals with whom you can speak to regarding client information. This is especially useful when you’re working as part of a care team with other health providers. Typically, this includes other doctors, nurses, and behavioral specialists, but in some cases could include a client’s family or guardians.

If You Accept Insurance

  • Insurance Information (optional): If you take insurance, find out your client’s insurance information early on in your conversations. This way, you’ll know what services are covered. Plus, you’ll have their information on file.
  • Superbill: If you don’t bill to insurance, or request that your clients submit claims directly to their insurance provider, you can provide a Superbill. We generally recommend preparing it immediately following a client appointment.
  • PCP Follow-up form: If another provider referred a client, sending a follow-up note to summarize your visit is a good idea. Typically, this is a modified version of your chart note, with additional summary information.
    • Pro-tip: Good and timely communication is a great way to build strong relationships with referring providers!


Now that you know which forms you should have, don’t you wish your physical paperwork would go away? With Healthlie, clients are automatically sent your intake paperwork. They can complete these forms electronically (even before your initial appointment). Then, their information is stored in one secure place. Plus, Healthie practitioners can use our templates to save time!


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