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Nutrition Referrals

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· Mail or fax nutrition referral form to the Durham County Department of Public Health, Nutrition Clinic. 

 · Referrals can be made by anyone. If signature of medical care provider is not available, name and contact number for provider must be given and referral form signed by patient or parent.

 · Upon receipt of the referral, client will be contacted by the Nutrition Division to schedule a nutrition visit at the Nutrition Clinic or at the client’s home.

 · After the nutrition visit, the nutritionist will send a summary of the nutrition encounter to the referring provider.

· Subsequent nutrition visits will be scheduled as needed by the nutritionist and client.

· Fees for nutrition services are based on a sliding scale fee.  Medicaid, Medicare Part B, BC/BS, Aetna are billed.

  

The Nutrition Division is staffed with licensed dietitians/nutritionists who specialize in nutrition care for pediatrics; obstetrics; and adults. For more information or questions call the Nutrition Clinic at 919-560-7791 or 919-560-7837 for service in Spanish.

 

 Examples of indications for nutrition visit:

 dotb  Inappropriate growth in children
 dotb  Overweight/obesity
 dotb  Diabetes or pre-diabetes
 dotb  Other- including client request for nutrition visit

 

Adult Referral Form

Pediatric Referral Form