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NUTRITION SCREENING QUESTIONNAIREName:Date:DOB:M/F(circle) Email:Phone: (Home)(Mobile)Emergency contact (Name):(Phone):Health Care Professional (Name):(Phone): Do you consent to information being
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Nutrition screening questionnaire is a tool used to assess an individual's nutritional status and identify any potential risks or deficiencies.
Healthcare professionals such as doctors, dietitians, and nurses are usually responsible for conducting and filing nutrition screening questionnaires for their patients.
Nutrition screening questionnaires can be filled out by answering a series of questions regarding dietary habits, weight changes, medical history, and other relevant factors.
The purpose of a nutrition screening questionnaire is to identify individuals who may be at risk for malnutrition or other nutritional issues, and to implement appropriate interventions.
Information such as dietary habits, weight changes, medical history, and any symptoms of malnutrition should be reported on a nutrition screening questionnaire.
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