Amy Shults RDN, CDN, CDE
Registered Dietitian Nutritionist & Certified Diabetes Educator

Resources and Documents

Patient Paperwork

New Patient Form

HIPAA Notice of Privacy Practices

Authorization for Release of Protected Health Information to AMS

Authorization for Release of Protected Health Information from AMS

Office Policies

Example Billing Policy (you will provided your own unique billing policy at your first appointment)

No-Show Policy

Documents

Blood Sugar Log

Carbohydrate Counting Log

Food Log

Resources

Niagara and Orleans Diabetes Resource Guide

 

64 Davison Court

Lockport, NY 14094

Tel: (716) 266-6056
Fax: (716) 332-6412

amy@AMSnutritioncounseling.com

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AMS Nutrition Counseling PLLC

64 Davison Court

Lockport, NY 14094

Phone: (716) 266-6056

Fax: (716) 332-6412

  • Facebook - White Circle