Print and fill this ICD-10 form, fill, and fax to 800-800-9560. Please send any labs with your referral form.

Got Staff?

We like to share our SMARTS! As a complimentary service, we can provide nutrition in-service sessions to your medical office team.


  • What Medical nutrition therapy can and can't do for your patients
  • Bring weight loss into your practice. Easy turn key with potential for new revenue
  • "Why Weight?" Why referring your patients for weight management is critical.
  • Other topics available upon requests

Have questions? Give us a call at (469)-619-6921.