Medicare requires a doctor's referral to a dietitian for Medical Nutrition Therapy. Currently, Medicare only covers nutrition visits for diabetes and kidney disease. Medicare offers 3 hours of nutrition counseling in the first year with a dietitian and 2 hours per year after that. Additional hours may be requested by your physician if your treatment plan or condition changes. Please have your medical provider's office complete the below referral form.
Referral Form for Medical Nutrition Therapy
Online Referral Form for Medical Nutrition Therapy
If you would like your medical provider to release your health information (chart notes, labs, reports) to the dietitian, complete the authorization form and provide it to your provider who should then fax the requested information to us.