Schedule a Follow Up Appointment Please complete the information to begin scheduling follow up sessions. Please complete the information and a staff person will contact you to schedule sessions with our Registered Dietitian. Each 30 minute session is $45. Follow ups are for additional sessions after an Initial session. Personal InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email* Date* Date Format: MM slash DD slash YYYY Health InformationNutrition Concerns*Describe your nutrition concerns and goals--tell us what you would like to get out of these sessions. Such as: I want to better control my Diabetes, I would like to help feed my family healthier, or I want to lose weight to feel better--inside and out. SchedulingWhen was your last session? Date Format: MM slash DD slash YYYY Appointment preference daysWhat days work best for you? Mark all that apply. Monday Tuesday Wednesday Thursday Friday Appointment preference timesWhat times work best for you? Mark all that apply. Morning (8am-12Noon) Afternoon (1:00pm-4:00pm) Evening (5:00pm-7:00pm) Appointment formatWould you prefer appointments: Over the phoneOn a video chat, such as ZoomI don't have a preferenceConsent* I understand that I must make payment for all of my appointments when I schedule. A staff member will contact you to schedule your appointment(s) within 72 hours of your request.