Whether you need Nutrition Counseling for a chronic condition or would like assistance in creating a balanced nutrition practice, our team is here to support you with your needs. Please fill out the new client forms below prior to your appointment.
If you are a New Client please complete the following forms/steps prior to scheduling your first appointment:
- New Client Agreement Form
- Contact your Health Insurance provider to confirm the following:
- Does your plan cover Nutrition Counseling visits?
- How many visits do you have per the calendar year?
- Do you have a co-pay for Nutrition Counseling visits? If so, what is it?
- Do you need a referral from your Primary Care Physician?
- If your plan requires a referral from your primary care physician, please contact your doctor’s office and have a referral faxed to us at: (508)-437-8163.
New Client Agreement Form:
Please click on the following link to complete the New Client Agreement form prior to your first appointment.
- You can complete the agreement and email it to us at: email@example.com
- Or print it and bring it with you to your first appointment.
Health Insurance Information Form:
Please note that we accept the following insurance carriers. If you do not have one of the following insurance carriers, or if your insurance plan does not cover Nutrition Counseling visits, the out of pocket payment is: $100 for the Initial Visit and $85 for Follow-Up visits. We are open to discussing payment plans to meet your financial needs.
Accepted Health Insurance Carriers:
- Blue Cross Blue Shield
- Harvard Pilgrim
- Neighborhood Health Plan
- United Healthcare
*Please note that we currently do not accept the following plans:
- Steward Healthcare Insurance Plans
- Tufts Network Health (ID starts with the letter N)