referral form for medical nutrition therapy (providers only)
LG Nutrition welcomes referrals from other health practitioners. We frequently receive referrals from physicians, physical therapists, functional medicine doctors, chiropractors, naturopaths, dentists, acupuncturists, and mental health providers. Please complete the form below to refer a patient.
Please note if patient has Medicare insurance and is being referred for diabetes or renal disease, please use our fax referral form.