Get the free Seattle Diet Prescription Form NEW 9-09.doc
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Send completed form to: Seattle Public Schools Nutrition Services, Administrative Dietitian P.O. Box 34165 / MS 32-372 Seattle, WA 98124 Phone: 206-252-0675 Fax: 206-252-0664 Diet Prescription for
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How to fill out seattle diet prescription form
How to Fill Out Seattle Diet Prescription Form?
01
First, gather all the necessary information such as the patient's full name, date of birth, and contact details.
02
Next, provide details about the healthcare professional issuing the prescription, including their name, credentials, and contact information.
03
Identify the patient's current medical condition and any specific dietary requirements or restrictions that need to be addressed in the prescription.
04
Specify the duration for which the diet prescription is valid and any specific instructions or recommendations for the patient to follow.
05
Indicate any recommended calorie intake, macronutrient distribution, or specific foods to include or avoid in the diet.
06
If applicable, include information about any supplements or medications that need to be incorporated into the diet.
07
Sign and date the prescription form, ensuring the healthcare professional's signature and contact information are provided.
08
Make a copy of the completed form for your records before submitting it to the appropriate healthcare facility.
Who Needs Seattle Diet Prescription Form?
01
Individuals with specific medical conditions that require dietary modifications may need a Seattle diet prescription form. These conditions can include diabetes, cardiovascular disease, obesity, or food allergies, among others.
02
Patients who are under the care of healthcare professionals such as dietitians, nutritionists, or doctors may require a diet prescription form to ensure proper dietary management.
03
Seattle diet prescription forms may be necessary for individuals participating in clinical trials, research studies, or weight loss programs that require dietary monitoring and intervention.
Remember, it is always best to consult with a healthcare professional or licensed dietitian/nutritionist for personalized guidance regarding diet prescriptions and individual dietary needs.
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