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WIC #867 (revised May 2015) Table of Contents PREFACE ..............................................................................................................................................................................
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How to fill out nutrition risk factor paper

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Start by gathering all the necessary information. You will need to note down personal details of the individual, such as their name, age, gender, and contact information. This will help in identifying the person who needs the nutrition risk factor paper.
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Proceed to assess the individual's medical history. Note down any existing medical conditions, allergies, or previous surgeries that may impact their nutritional needs. This information is essential in determining the risk factors associated with their nutritional health.
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Next, evaluate the individual's dietary habits. Ask about their current eating patterns, including the types of foods they consume and their portion sizes. This will provide insights into their nutritional intake and potential deficiencies.
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Record any symptoms or signs of nutritional deficiencies or imbalances. This may include issues like weight loss, fatigue, digestive problems, or changes in appetite. Documenting these factors can help in identifying specific risk factors.
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Consult with a registered dietitian or healthcare professional if needed. They can provide expert guidance in evaluating the individual's nutrition risk factors and offer appropriate recommendations for improvement.
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Finally, summarize the findings and recommendations in a clear and concise manner on the nutrition risk factor paper. This document will serve as a tool for ongoing assessment and monitoring of the individual's nutritional status.
Who needs nutrition risk factor paper?
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Individuals who are seeking to evaluate their overall nutritional health.
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Healthcare professionals or dietitians who are conducting nutritional assessments or creating personalized diet plans for their patients.
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