Referral Forms & Provider Resources

Thank you for partnering with One Bite at a Time Nutrition Counseling.
This page includes everything needed to refer a patient quickly and easily.

Fax Referral Form

Faxing this form allows us to verify insurance coverage and contact the patient directly.

Download Fax Referral Form (PDF)

Print-friendly • Most commonly used

Additional Resources – Cheat Sheets for Specific Disciplines

These optional cheat sheets are tailored to common referral scenarios by specialty. The general referral form above is always acceptable.

Primary Care – Refer to Us When… Cheat Sheet (PDF) Endocrinology – Refer to Us When… Cheat Sheet (PDF) Gastroenterology – Refer to Us When… Cheat Sheet (PDF) Behavioral Health – Refer to Us When… Cheat Sheet (PDF) OB/GYN – Refer to Us When… Cheat Sheet (PDF)

What Happens After You Fax a Referral?

- Insurance coverage is verified
- The patient is contacted within 1–2 business days
- Confirmation is sent back to your office

Need help or have questions?

Phone: 330-720-9676
Fax: 330-595-4644
Email: becky@onebiteatatime.org