Patient Checklist for Medical Nutrition Therapy - Crozer-Keystone Health System - PA

Nutrition

Patient Checklist for Medical Nutrition Therapy

The Patient Checklist is provided for your convenience. 

  1. Please arrive 20 minutes prior to your scheduled apt.
  2. Please park in the Springfield Hospital parking garage and follow the signs to Patient Registration on the main floor.
  3. Once you arrive, let the person at the patient registration desk know you have arrived for your nutrition appointment. The dietitian will be paged, and she will meet you at Patient Registration, and together, you will walk to the nutrition counseling office.
  4. Items to Bring
    • A referral from your physician is needed for all patients. You may either:
      • Option 1: Fax physician referral to 610-447-2325.
      • Option 2: Bring physician referral to your visit.
    • Medication List
    • Laboratory Results
    • Insurance Card
    • Photo ID
    • Co-Pay, if applicable

Disclaimer: A referral from your doctor or other healthcare provider is necessary for all appointments. If a patient forgets to bring the referral, the appointment will be discontinued and rescheduled.

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