Before DocRD™ Nutritional Consultation

Patient instructions before appointment:
First make your appointment and second please read below:
DocRD™ Nutritional Consultation | Option: DocRD™ e-consult MNT e-consultMNT.com

Medical Nutrition Therapy (DocRD™ Virtual) remotely (by telephone or Skype)

1. Request from your Physician a complete report of recent blood lab work.

Use this form

AUTHORIZATION TO RELEASE MEDICAL RECORD(s) (ID #9162)
This form can notify a doctor or staff to release a medical record(s) to your choice. Can be released to yourself, or a provider. See our privacy policy.
RE: Release of medical records
Please release my medical records related to recent lab results for medical rendered by you or under your supervision (can add expiration date-optional). This information will be used to further assist in my medical care, and should be mailed to:
Your Name or Name of Party to Receive Records
Street Address City, ST ZIP Code
Please bill me for costs associated with providing copies of my records, and I will remit payment promptly upon receipt of the records. Sincerely,
and after filling it out print a copy to send to your Doctor’s office and submit the form.

A. If your DocRD™ Nutritional Consultation is in person (either at our office or at your home):
Bring the lab report with you at the time of your appointment.

B. If remotely via telephone or Skype, send an e-mail attachment of your lab report to mg@HealthCareNutritionist.com (in subject put Patient  name, lab report.

2. Begin a 3-day Dietary Recall:

Either bring it with you or send as an attachment email. (Note: 3-day Dietary Recall is a note page with each day indicated (date) of a complete listing of everything you eat or drink and the amounts.)

A. An example of what you eat and drink: Turkey Sandwich, 2 pieces of whole grain wheat bread, 1 oz of sliced turkey, mayonnaise teaspoon, 2 slices tomato, lettuce, salt and pepper and 1 cup of water.
B. Does not have to be consecutive days can be Monday and Tuesday and then skip to Saturday as an example. If you don’t complete all three days, then bring what you can complete to the session. Be truthful and enjoy it.

I look forward to our session and for you to begin your journey to have your nutritional goals met. DocRD™