New Patients please click below or request the following forms and bring them with you to your first appointment. By filling out the forms ahead of time you can optimize your time with us. Email us at info@carlasfamilynutrition.com for the appropriate forms. Please bring any recent lab results and a 3 day food log to your visit to allow us to get a better insight into your health and habits. In addition please review our insurance, cancelation/no show and credit card policy below. 























New Nutrition Pre-Pregnancy


HIPPA Privacy Policy


Office Policies


Medical Records Release Form




Cancellation Policy

You will be charged $75 if you cancel/reschedule your appointment with less than 48 hours notice or do not show.

Why do we have a cancellation policy? Reaching your goals through healthier eating habits and regular physical activity requires planning, discipline, and being able to juggle various demands and commitments. Coming to your appointments is a way of saying “Yes!” to yourself. It is very hard for us to implement this formal policy although,  we believe that when you reach out to us for help with your eating and health you are looking, in part, for someone to hold you accountable. We believe that letting you cancel at the last minute without consequences is a disservice to you and the attainment of your goals.

Why do we require 48 hours and not 24? When you schedule an appointment, we reserve that time for you- sometimes it is reserved for a month but more often it is held for 6-8 weeks. When you call to reschedule with just 24 hours or less notice, it is unlikely that we will be able to fill your slot with another client.

Why is the cancellation charge $75? $75 is a portion of what we would have been paid by your insurance had you come to your appointment. Like all small business owners, we have numerous expenses including rent, telephone, continuing education (which includes tuition, airfare and lodging), liability & business insurance, advertising, computer, payroll,  taxes, etc.


Insurance


If your visit is covered by your insurance, you must have a copy of your insurance card and co pay at the time of visit.  If your appointment is not covered by your insurance you must make payment for services at the time of the visit. We cannot bill for services. 


Please provide a referral for nutrition services from your primary care doctor prior to your visit if your insurance requires prior referrals/authorization. If you do not have your referral or authorization you are required to submit payment in full for the visit. 

Credit Card Information

Insurance copayments, deductibles, and other fees differ significantly from plan to plan and are constantly changing.

To ensure that we receive payment of any deductibles, copayments or charges or fees for agreed to services not covered by your insurance, we ask for credit card information (or other appropriate security). No amount will be charged to your card until such non-covered deductibles, copayments, cost shares, charges or fees have been incurred.

Your credit card information or other appropriate security will be stored securely and shredded when all of your deductibles, co-payments or charges or fees for agreed-to-services not covered by your insurance have been paid and you are no longer a client at Carla Coriaty-Hulla RDN.



Carla's Family Nutrition & Wellness