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Need a Referral?

You may need a referral before you are seen; however, having a referral does not guarantee coverage. 

It is always best to check with your insurance beforehand. For questions to ask your insurance company click here.

Please click here for a nutrition referral for your primary care physician physician or specialist to complete. You do not have to have an appointment with your physician to have this form completed. It can be sent to his/her office and signed without you being present. 


Email or fax the completed form before your appointment:

Fax: 817-476-6133

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