top of page

Resources

Let's get to work!

Below are several resources that you may need to get started such as intake and release forms or a brief overview of which insurance plans are accepted for Nutrition and Dietetic Counseling. 

42977552_919569341576229_5638728989435494400_n.jpeg

Insurance Plans Accepted

Some policies may not cover all Nutrition and Dietetic Counseling Services. Clients should call and verify their insurance prior to their visit. All payments and copays are due at the time of appointment.

Insurance Accepted

Forms

Physician's Referral

Physicians and other medical offices who would like to refer patients to our office for Nutrition and Dietetic Services can utilize this form. 

Due to HIPPA please fax this form directly to the front office staff at (252) 917-8441. 

Photo Release

This form allows Crystal Coast Wellness to use our happy client's likeness such as images and direct quotations to help us promote your success as well as help us market and grow!

 

Please email this form directly to marketing@crystalcoastwellness.com or drop it by the front desk during office hours.

Nutrition Intake

This Nutrition and Dietetics Intake Form completion is required prior to your initial visit to enable the Dietitian or Nutritionist prepare for your meeting. Please attempt to have this form completed and sent in or dropped off at least 24hrs prior to your appointment. 

Please email this form directly to info@crystalcoastwellness.com or drop it by the front desk during office hours. 

Client Testimonial

This questionnaire is a handy prompt for our super satisfied clients to reflect and write on their experiences at our facility with our Dietitians and Exercise Specialists.

 

Please email this form directly to marketing@crystalcoastwellness.com or drop it by the front desk during office hours.

Personal Training Intake

The Personal Training Intake Form completion is required prior to your first appointment to help prepare the Exercise Specialist for your meeting. Please try to have this filled out and sent in or dropped of at least 24hr prior to your appointment. 

Please email this form directly to angelica@crystalcoastwellness.com or drop it by the front desk during office hours. 

Forms
bottom of page