New Patient Forms
If you are coming to Balance Fitness and Nutrition for your first appointment, please complete the Office Policy Forms and appropriate Questionnaire below. Send your paperwork to our office at least one day prior to your appointment.
Office Policy Forms
- Liability Policy
- Cancellation and Payment Policies
- HIPPA Policy (please sign and print last page only)
- Adult Nutrition Questionnaire (for those 17 years of age and older)
- Child Nutrition Questionnaire (for those 16 years of age and younger)
You may fax your paperwork to 678-550-9518 or email your paperwork to email@example.com. Additionally, if you have had lab work completed within the last year, please include a copy of your labs with your paperwork.
- The initial consultation is $175.00, payment is due at your appointment.
- Appointments may be paid for using check, cash and most major credit cards.
- Visits to a dietitian may be partially reimbursed by insurance.
- Please find out if you will receive reimbursement prior to your first appointment.
- To avoid additional fees, requests for insurance paperwork must be made during your appointment time.