--- title: Celiac Disease & Gluten Sensitivity Screening Form Template | Paperform description: Professional celiac disease and gluten sensitivity screening form with symptom tracker, antibody testing consent, biopsy scheduling, and nutritionist referral. HIPAA-friendly and customizable. url: "https://paperform.co/templates/celiac-disease-gluten-sensitivity-screening" type: static generatedAt: "2026-04-04T00:43:23.461Z" --- [← Back to free form templates](/templates/) ![Celiac Disease & Gluten Sensitivity Screening](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/celiac-disease-gluten-sensitivity-screening.png) [Preview](https://_preview.paperform.co/ai-template/celiac-disease-gluten-sensitivity-screening) [Use this template for free](/create?ai-template=celiac-disease-gluten-sensitivity-screening) [Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/) [Physician](/templates/role/physician/)[Nurse](/templates/role/nurse/)[Healthcare Administrator](/templates/role/healthcare-admin/)[Dietitian](/templates/role/dietitian/)[Nutritionist](/templates/role/nutritionist/) About this free form template ### Comprehensive Celiac Disease & Gluten Sensitivity Screening Managing celiac disease and gluten sensitivity screening requires careful documentation of symptoms, medical history, and patient consent. This **Celiac Disease & Gluten Sensitivity Screening form** helps healthcare providers, gastroenterologists, and medical practices streamline the assessment process while ensuring thorough patient evaluation. #### Why use this screening form? This template is designed for healthcare professionals who need to assess patients for celiac disease and gluten-related disorders. It captures detailed symptom tracking, family history, dietary information, and coordinates follow-up testing and specialist referrals—all in one organized, patient-friendly form. **Key features include:** - **Detailed symptom tracker** covering digestive, nutritional, and systemic symptoms - **Medical and family history** documentation for comprehensive risk assessment - **Antibody testing consent** forms built right into the workflow - **Biopsy scheduling** coordination with calendar integration - **Automatic nutritionist referrals** based on screening results - **HIPAA-compliant data collection** with secure submission handling #### Perfect for medical practices of all sizes Whether you're running a gastroenterology practice, primary care clinic, or specialized digestive health center, this form adapts to your workflow. Use conditional logic to show relevant follow-up questions based on symptom severity, and connect to your practice management system through **Stepper** (stepper.io) to automatically create patient records, schedule appointments, and trigger care team notifications. The form's professional design ensures patients feel comfortable providing sensitive health information, while the structured format gives your care team the data they need to make informed diagnostic decisions. Replace outdated PDF intake forms and scattered email communications with one streamlined digital experience. With Paperform's HIPAA-friendly features and SOC 2 Type II compliance, you can trust that patient data is handled securely from submission through to your EHR system. Start using this template today to improve your celiac screening workflow and provide better, faster care for patients experiencing gluten-related health concerns. Built for growing businesses, trusted by bigger ones. Trusted by 500K+ business owners and creators, and hundreds of millions of respondents. ![Capterra - 4.8 out of 5](/images/capterra-st.jpg) ![Trustpilot - 4.8 out of 5](/images/trustpilot-st.jpg) ![G2 - 4.8 out of 5](/images/g2-st.jpg) [Try Paperform free now](/register) ## More templates like this [![Medical Weight Loss Program Enrollment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/medical-weight-loss-program-enrollment-form.png) ### Medical Weight Loss Program Enrollment Form Comprehensive patient intake form for medical weight loss programs with automated BMI calculation, metabolic health assessment, eating behavior evaluation, and personalized goal setting.](/templates/medical-weight-loss-program-enrollment-form/) [![Prediabetes Screening & Prevention Program 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