Referring Providers

Thank you for allowing me to serve your patients! Check out the step-by-step guide below for sending referrals. If you have any questions or issues, please contact me.

  1. Print referral form here.
  2. Complete all information requested on form and sign.
  3. Physician or provider must sign and date. Please include printed name of physician/provider.
  4. Fax form to number listed on referral form.
  5. The Registered Dietitian will contact the patient to schedule an appointment.
  6. Your office will be faxed about appointment once the patient has been contacted.
  7. After the patient is seen by the RD, a summary note will be faxed to your office. RD recommendations will be provided.
  8. Follow-up visits may be scheduled as needed and follow-up notes will be faxed to you.

Fee for service is listed on the Schedule Now page.

Insurance Accepted: Blue Cross Blue Shield, Medicare, and United Healthcare. Major credit cards, HSA, and FSA cards accepted.

Blue Cross Blue Shield Insurance Provider
United Healthcare Provider
Medicare Preferred Provider
FSA and HSA Cards accepted

Virtual appointments are available Monday – Friday between 8:30 am and 5:00 pm. Some Saturday appointments also available.
Patients will be contacted by phone to schedule an appointment once a referral is received.

Patients may also schedule an appointment online at www.claytonnutrition.com by clicking on Schedule Now under Nutrition Services tab and choosing the desired appointment date and time. Please feel free to contact me if you have any questions. Thank you for your referrals.

  • Contact Information:
    • Phone: (336) 355-5756 call/text
    • E-mail: Lynn@claytonnutrition.com
    • Fax: (844) 335-7607

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