“Start with a blank sheet” is an open-ended approach to the nutrition assessment that encourages a conversation-style interaction between provider and patient rather than a structured questionnaire-style assessment. This chapter emphasizes the importance of prioritizing the information most pertinent to the reason for referral and trusting that the patient will tell you what they need. Also included are practice tips on how to break the ice to help the patient feel comfortable in sharing their story. Ultimately, the goal of the assessment is to find out what the patient wants to know as well as what they need to know—which are not always the same things.