New Patients - General Information
Because this is the beginning of what we hope is a long, happy and healthy relationship - we'd like to make getting started as easy as
1- Make your First Appointment
Speak with our friendly assistants at 678-407-2159 to make your first appointment or click on CONTACT ME.
For Telemedicine, Virtual Counseling, write us at CONTACT ME.
2 - Patient Information Forms
Before your first visit, please, fill out the on-line form and then, click on "SUBMIT" in the bottom of the page.
You will receive a confirmation email from us.
~ Patient Personal Information form:
for youth, 19 years or older, click on Adults' Form
for kids and youth up to 18 yeas old, click Kids &teens' Form
for before, during and after Pregnancy, click on Moms' Form
3 - Financial Policy
Please review our Financial Policy, Financial Responsibility Agreement and Schedule Policy.
4- Privacy Information
This describes how medical information about you may be used and disclosed and how you can get access to this information, HIPAA
5 - Patient Billing - Insurance coverage
Insurance coverage for Medical Nutrition Therapy is dependent upon the insurance company as well as your insurance plan.
In-network provider - Health Insurances
Out-of-network - You will be provided with a "superbill" that includes the insurance coding needed for reimbursement at the end of your
appointment. You have to submit it yourself to your Insurance Company or apply it toward your flex spending account.
For this reason, payment is expected when services are rendered.
*** If your Health Insurance does not cover medical Nutrition Therapy and your doctor fills the on-line "Medical Referral Form" you will have
a 20% off in your individual fees.
Forms of payment accepted: Check, cash, credit cards (with added 3% fee)
6 - Missed / cancelled Appointments
If you need to cancel an appointment, please do so at least 48-hour in advance, 678-407-2159. Patients who fail to show-up for a
scheduled appointment without providing us with at least 48 business hours notice will be charged a $30 fee.
7 - Virtual Counseling/ Webcam / Phone Consulting Support
As an active client of NutritionECW.com, Virtual Counseling /webcam or phone calls are reserved and paid in advance. Usually these
sessions are provided for patients with special needs or demands (distance or others). However, this service is only provided with previous
consent between Eugenia Couchoud-Wilkinson MS, RDN, LD and the patient or patient's guardian.
Virtual counseling, is usually done as follow-up care, nutrition education or when individual treatment plan is progressed or adjusted but
never as a first Nutritional Evaluation.
Fees and discount packages are the same as the regular visits.
If you are interested in virtual counseling, write us at CONTACT ME.
Make an appointment
LENOX - JOHNS CREEK - LAWRENCEVILLE
Copyright © 2012 -All Rights Reserved - NutritionECW, LLC.
Registered Dietitian/Nutritionist serving Atlanta, Johns Creek, Suwanee, Duluth, Lawrenceville - Georgia