1st: Please Register Here
2nd: Click on links below
Policy of Service (POS)
Weight History fill this form only if weight loss is a goal
3rd: Print the pdfs. Complete all forms and sign POS. Scan & Email all forms to:
4th: Customized payment (you must speak to Diana first)
Enter Payment of fee amount for deposit, package, consultations and/or product(s) discussed.
Dear Potential Client:
Thank you for your interests in my services. I am eager to coach you to gain the maximum knowledge and skills that you need to attain your health and wellness goals. If you've never worked with a functional medicine nutritionist trained in mental health and wellness counseling then you are probably asking yourself, what should I expect when working with Diana. When you work with me, I will review your intake form and then recommend specific conventional and functional medicine lab for your health issue which we will arrive at during our first 30 minute consultation. Once your lab results are completed, I will educate you on the foods, USP or cGMP-NSF certified nutraceuticals, cognitive behavioral therapy, mindfulness and state of the art lifestyle medicine tactics that are steeped with evidence based data to improve your health. You will be given a specific personlized CHIP (Continuous Health Improvement Plan) to follow. My therapy is highly specific to YOU and your personal health goals. Through my 28 years of expertise in clinical nutrition, functional medicine nutrition therapy and neuro-cognitive coaching you will be motivated to take action! As soon as you complete the three forms (intake form, policy of services, weight history) and send them in, I will contact you to schedule an appointment.
In order to set up an appointment with me you will need to purchase an initial package which includes the following: The package fee is $300 initial
If you need additional service once we’ve completed our initial consultation package, which means you are an establish patient, you may choose from the following services. You may request phone consultations, customized meals plans, skype or internet consultations as part of your consultations with me.
For insurance coverage you will need to check with your insurance carrier to assess coverage for my services. If you have a medical condition, your insurance carrier may reimburse for my services; however, please note, I do not bill for insurance, but I will provide you with the necessary form to submit to your insurance carrier for potential reimbursement. When checking on coverage, if your insurance company needs to contact my office for my credentials and licensure, please provide them with my clinic’s number. My staff is equipped with this information and will be happy to provide your insurance carrier with my credentials.
To Your Best Health To Come,
Diana Davis, M.Ed., LDN, RDN
Functional Medicine Nutrition Practitioner
Medical Registered Dietitian
Licensed Clinical Nutritionist
Additional Packages once you are an established client
2-45 minute visits or 1-1.5 hour visit
3-45 minute visits
6-45 minute visits
10-45 minute visits
12 monthly sequential, 30 minute Nutrition and Neuro-Health Coaching
Metabolic & Segmental Body Composition test
Book Diana for a speaking engagement, request an article,
or develop a wellness program for your Organization or Corporation!
Please fill out form and submit.