Bariatric New Patient Questionnaire & Forms

This packet is due to our office prior to your initial telehealth consultation with the dietitian.  Failure to complete it will result in cancelation of your appointment.  Please see our financial policy for missed appointment fees. 

Follow-Up and Non-Bariatric Questionnaire 

If you have a follow-up scheduled or are a non-bariatric client with an initial consultation please complete this packet. 

Fax Coversheet

Please complete and attach this cover sheet to ALL incoming faxes. 


Our fax number is



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