Re: Starting a consulting business

[Guest guest]

,

Although RD-USA is not set up to accept email attachments it would be

great if you posted your forms on the RD-USA website. Click on " Visit

your group " at the end of this message, make sure you are signed in to

yahoo groups, then click " files " on the left. It's easy to upload

documents there to an exisiting folder or start a new one.

Pat

>

> Well, darn - didn't realize it wouldn't work.

>

> Copy and pasted.... I know this isn't the best way to share, but I

> thought it might be beneficial to others also that didn't want to

> reinvent the wheel.

>

> Authorization for release of information

>

> I authorize Lawson, RD, LD/N

> 1664-2 Metropolitan Blvd.

> Tallahassee, FL 32308

>

>

> To exchange records with

> _______________________________________________

> (Name of receiving person)

>

> _______________________________________________

> (Address)

>

> _______________________________________________

> (City, State, Zip)

>

> _______________________________________________

> (Telephone Number)

>

> With regard to

> _______________________________________________

> (Patient's Name)

>

> _________________________________ _________________________

> (Signature of Responsible Person)

>

> Lawson, RD, LD

> Dietitian/Licensed Nutritionist

> Fax Cover Sheet

> Phone Number:

>

> Fax To:_______________________________ Date: _______________

>

> Fax Number: _______________ Phone Number:__________________

>

> Number of Pages (including cover sheet): __________

>

> __________________________________________________________

>

> Informed Consent

> Welcome! I will make every effort to be sensitive to your needs and

> assist you in addressing the concerns that are brought to my

> attention. In order to best help you, I believe it is important for

> you to be aware of some of my policies. Please review the items listed

> below giving me consent to provide services. Thank you.

>

> * Payment is expected at the time of service. Initial assessments are

> $100 and follow up sessions are $65. I do not bill for my services.

>

> * I accept check or cash as my only forms of payment.

>

> * If you are a CHP member, you are responsible for your copayment at

> the time of service. The services I will be providing are considered

> specialized treatment.

>

> * I do not schedule CHP clients until you have been authorized. But

> please realize that authorization to see me does guarantee payment

> from CHP. You will be responsible for payment if CHP denies your claim

> or only pays a portion of the claim.

>

> * Initial assessment sessions are approximately 45 minutes - 1 hour in

> length.

>

> * Follow up sessions are approximately 30 minutes in length.

>

> * If I have not seen you in 3 months and you would wish to restart

> services, then the first appointment would be considered an initial

> assessment.

>

> * I schedule appointments throughout the day and must adhere to my

> planned schedule. I will always try to start our session at the

> appointment time. However, if I am running late, you will receive your

> full session time. On the other hand, if you are running late, the

> session will have to end at the original time to be considerate of

> other's scheduled times.

>

> * I require a 24-hour cancellation. If it is less than 24 hours, then

> you will be charged for the session.

>

> * CHP does not cover missed sessions, therefore, if less than 24 hours

> notification was given then you will be responsible for the fee.

>

> * I follow HIPPA Guidelines to protect confidentiality during your

> treatment. This means that all the information you disclose to me will

> be treated as private and confidential and will be disclosed only with

> your written permission by signing a Release of Information Form.

>

> * CHP members are responsible for initiating referrals from their

> primary care physicians. You are also responsible for tracking your

> number of approved visits. After your approved visits have expired and

> continued therapy is desired, then you will be responsible for the

> payment.

>

> _____________________________________ _____________________

> CLIENT SIGNATURE DATE

>

> _____________________________________ _____________________

> PARENT SIGNATURE (if client is a minor)

>

> MEAL PLAN

>

> BREAKFAST

>

> MIDMORNING SNACK

>

> LUNCH

>

> AFTERNOON SNACK

>

> DINNER

>

> BEDTIME SNACK

>

> STARCH

>

> FRUIT

>

> MILK

>

> VEGETABLE

>

> MEAT

>

> FAT

>

> SUPPLEMENT

>

> DATE: ________________________________________

>

> CALORIES: _______________________

>

> NOTES:

>

> Height: _____________________ Weight: ____________________

>

> __________________________________________________________

>

> __________________________________________________________

>

> __________________________________________________________

>

> __________________________________________________________

>

> __________________________________________________________

>

> __________________________________________________________

>

> __________________________________________________________

>

> __________________________________________________________

>

> PLAN: __________________________________________________________

>

> __________________________________________________________

>

> __________________________________________________________

>

> ___________________________________ ________________________

> Lawson, RD, LD

>

> Lawson, RD, LD/N

> Registered Dietitian, Licensed Dietitian

>

> Name: _____________________ Date: ____________________

> Address: _____________________________________________________

> Phone Number: ___________________ (home)

> ___________________ (cell)

> ___________________ (work)

> Social Security Number: _____________________________

> Date of Birth: __________________________

> If under 18 years of age, Parents name:

> _______________________________________

> Parents phone number: ________________________________

> Parents address: ______________________________________

>

> If Capital Health Plan client:

> CHP Identification number: _____________________

>

> Primary Care Physician (name/telephone number):

> ___________________________________

> Whom may I thank for referring you to my office?

> ___________________________________

>

> Reason for visit:

> __________________________________________________________

> __________________________________________________________

> __________________________________________________________

> I give my written consent authorizing Lawson, RD, LD/N to

> release general information regarding my nutrition therapy to (please

> include name and number): ____________________

> __________________________________________________________

> Name: _________________________ Date: _____________________________

> Parent Name (if minor): _________________________ Date: __________________

>

> From: rd-usa <mailto:rd-usa%40yahoogroups.com>

> [mailto:rd-usa <mailto:rd-usa%40yahoogroups.com>] On

> Behalf Of Lawson

> Sent: Tuesday, October 26, 2010 8:16 AM

> To: rd-usa <mailto:rd-usa%40yahoogroups.com>

> Subject: RE: Starting a consulting business

>

> I've attached some documents that I use. Hope this helps

>

>

>

> From: rd-usa

> <mailto:rd-usa%40yahoogroups.com><mailto:rd-usa%40yahoogroups.com>

> [mailto:rd-usa

> <mailto:rd-usa%40yahoogroups.com><mailto:rd-usa%40yahoogroups.com>] On

> Behalf Of Nowak

> Sent: Monday, October 25, 2010 6:17 PM

> To: RD USA

> Subject: Starting a consulting business

>

> Hi all! I know this topic has been brought up before, but I just

> happened to

> have an opportunity to start doing a small amount of individual nutrition

> consulting and need some advice/tips. Is there any quick resource

> about where

> to start with pricing/resources/needs, etc. I still have three kids at

> home and

> would likely be doing this on an extremely limited basis with a very

> small list

> of clients. I know I need liability insurance and to be licensed in my

> state.

> I've kept my RD current, but for the last three years, I've only

> taught the

> occasional cooking class.

>

> I'm out in Northern Utah and just want to make enough to offset

> expenses with a

> little left over. I no longer belong to ADA because of the cost and

> was not

> working outside the home. Thanks in advance for any help.

>

> Nowak

> Hyde Park, UT

>

>