đ Module 11: Health Assessment Builder
Intake + consult scoring that converts.
2. Why It Matters
Done right, a health assessment is more than a questionnaireâitâs a lead magnet, a diagnostic, and a sales script. It removes guesswork on consult calls, shows prospects you understand their world, and gives business leaders a lowârisk way to sample your value.
With light scoring and clear next steps, you move from vague conversations to targeted recommendationsâmaking it easy for clients (and companies) to say âyes.â
3. Step-by-Step Guide
Pick One Audience & Outcome
Decide if this is for 1:1 leads, current clients, or employees. Define the single outcome: lead capture, consult prep, or company pilot. Name it (e.g., Thrive Score or Wellness CheckâIn).
Draft Sections & Scoring
Use 6â8 sections (energy, sleep, nutrition, stress, movement, mindset, work). Keep ~85â90% multipleâchoice, 10â20% scales, 5â10% short text. Assign simple risk points to each option (higher points = higher risk).
Build in Google Forms
Create sections, mark key questions âRequired,â turn on email collection, and add short helper text under complex questions. Use âGo to section based on answerâ for simple branching.
Brand & Embed
Add your logo/colors and embed on a page (e.g., /assessment). Place a sticky CTA linking to your scheduler and a privacy note: âResponses are confidential.â
Automate to CRM + Calendar
Send new responses to Sheets/Airtable, tag score tier, and trigger an email with your booking link. Optional: autoâcreate a calendar event when someone books.
score_tier so itâs visible in your pipeline at a glance.Pilot, Review, Improve
Run 10 test completions. Watch where people drop off, shorten unclear items, and tighten copy. Track completion â booking rate to benchmark.
Package for B2B
Offer a 3â5 minute âEmployee Wellness Check.â Aggregate results into a 1âpager with 3 insights + 3 recommendations + your program CTA.
4. Examples & Options
Consult Script (Use This)
Open: âBased on your responses, I noticed sleep and midâday energy dips.â
Mirror: âYouâre getting 5â6 hrs and skipping lunchâsound right?â
Diagnose: âThese two drive cravings and afternoon crashes.â
Prescribe: âIn my 12âweek plan, weeks 1â2 fix sleep timing and a simple proteinâfocused lunch. Want help implementing?â
Three Implementation Paths
DIY (free): Google Forms â Google Sheets â Calendly, singleâstep Zap.
Midâlevel: Typeform (logic + design) â Zapier â Airtable/HubSpot Starter.
Advanced: Jotform (HIPAA) â Zapier â CRM (HubSpot/Keap) + Looker Studio dashboard.
Scoring Example
Each domain 0â4 pts. Totals: 0â8 Green (maintain), 9â16 Amber (coach fix), 17â32 Red (priority plan). Autoâtag tier in your sheet.
Question Bank (CopyâReady ⢠Pick & Choose)
Keep tone friendly and plainâlanguage. Prefer multipleâchoice over long text.
1) WorkâLife Balance
⢠âHow often do you have enough time for yourself?â (Always â Never)
⢠âHours of work on a typical day?â (<6, 6â8, 8â10, 10â12, 12+)
⢠âDo you take regular breaks?â (Hourly, 1â2/day, Rarely, Never)
⢠Open: âOne change to improve balance?â
2) Current Health Status
⢠Overall health (Excellent â Poor)
⢠Common issues (multiâselect): fatigue, headaches, digestion, sleep, anxiety
⢠Sleep hours (7â9, 5â6, <5, 9+)
⢠Open: âBiggest health concern?â
3) Stress Levels
⢠Frequency (Rarely â Constantly)
⢠Sources (work, finances, family, health, perfectionism)
⢠Coping (healthy outlets, distracting, unhealthy, none)
⢠Stress 1â10
4) Job Satisfaction
⢠âHow do you feel about going to work?â (Excited â Miserable)
⢠âDo you feel valued?â (Always â Never)
⢠Alignment with longâterm goals (Yes â No)
⢠Open: âOne change to improve satisfaction?â
5) Nutritional Health
⢠Balanced meals frequency (Always â Rarely)
⢠Food issues (bloating, reflux, crashes, cravings)
⢠Water intake (8+ cups â <3 cups)
⢠Open: âBiggest nutrition challenge?â
6) Physical Health
⢠Activity frequency (Daily â Rarely)
⢠Chronic pain (No â Constantly)
⢠Mobility issues (flexibility, distance, joints, posture)
⢠Open: âOne fitness goal this quarter?â
7) Mental Health
⢠Overwhelm frequency (Never â Constantly)
⢠Sleep quality (Excellent â Poor)
⢠Anxiety frequency (Never â Constantly)
⢠Joyful activities (Daily â Rarely)
8) Life Satisfaction
⢠Overall life satisfaction (Very â Very dissatisfied)
⢠Alignment with values (Yes â No)
⢠Area to change (Career, Relationships, Health, Finances, Growth)
⢠Open: âOne thing that would make life better now?â
5. Common Mistakes to Avoid
⢠Too long. Instead of 40+ items, ship a tight 15â25 and iterate from data.
⢠No clear CTA. Donât end with âThanks.â Instead, route to âBook your 15âmin review.â
⢠No scoring. Instead of eyeballing results, use a simple tier (Green/Amber/Red) to guide the consult.
⢠Clinical tone. Swap jargon for approachable language to increase completion rate.
⢠No followâup. Automate an instant email + booking link while motivation is high.
6. Quick Win Highlight
đĄ Quick Win: Build a 8âquestion miniâassessment in 10 minutes. Use one question per domain (workâlife, health, stress, job, nutrition, physical, mental, life). Make all multipleâchoice, add a short confirmation message with your Calendly link, and publish.
Copy sample items: âHow rested do you feel most mornings?â (Very, Somewhat, Rarely, Never) ⢠âHow many days do you move 30+ min?â (0, 1â2, 3â4, 5+)
Mark Complete â7. Mini-Implementation Exercise
Fill this worksheet before you build:
| Domain | Top 2 Questions | Risk Signal | Points |
|---|---|---|---|
| Sleep | 1) Wake rested? 2) Hours/night? | Rarely rested; <6 hrs | 3â4 |
| Energy | 1) Midday slump? 2) Caffeine reliance? | Daily slump; 3+ cups | 2â3 |
| Nutrition | 1) Balanced meals? 2) Water intake? | Rarely balanced; <3 cups | 2â3 |
| Stress | 1) Stress level 1â10? 2) Coping? | âĽ7; unhealthy coping | 2â4 |
| Movement | 1) Days 30+ min? 2) Sitting hours? | 0â1 days; 9+ hrs | 2â4 |
CTA & Routing: Confirmation message â âThanks! Book your 15âmin reviewâ + link. Email autoâreply with score tier + booking.
8. Tools & Resources
Fast, free, reliable. Great for MVP and easy embedding.
Slick UX + logic jumps to keep completion rates high.
Privacyâfriendly option when handling sensitive data.
Send responses to Sheets/CRM, compute score tiers, trigger emails.
Store responses, add computed columns, filter by score tier.
Embed a booking flow on the thankâyou screen and emails.
9. Checkpoint / Success Criteria
10. Summary & Next Step
- Your assessment is a lead magnet, diagnostic, and consult script in one.
- Keep it short, mostly multipleâchoice, and score into 3 clear tiers.
- Automate capture â tag â email â booking to remove friction.
- Package aggregated insights for businesses as a simple 1âpager.