Nutritional Counseling - Forms
For your first visit, please print all documents below, fill out, and bring to your initial appointment. Failure to complete these documents will result in rescheduling of your appointment and a $20 rescheduling fee.
- Food Diary Template and Instructions
- Dietitian History, Questionnaire and Asssessment
- Authorization for Release of Information (If you are wishing for Karin Hosenfeld MS, RD, CSSD, LD to communicate with your doctor or therapist.)
Advice from a Registered Dietitian is NOT a substitute for diagnosis by a medical doctor (MD). For certain conditions, Karin may refer clients to an MD for further evaluation. All adults should follow up with their primary physician at least annually for evaluation.