Doctors and Practitioners

Refer your patient / Collaborate

We can work together to help our patient/clients resolve symptoms through Therapeutic Carbohydrate Reduction.

Refer your patient/client to Eat For Health to help them lower A1C levels with a safe, clinically proven, and well-formulated low-carb eating plan? Share the referral form below with your patients. We offer a 20 minute complementary call for each with no financial obligation:

Eat For Health LLC is privately owned and operated; not connected with Medicare, Medicaid, or other government programs, and not regulated by HIPPA. Therefore, please DO NOT INCLUDE PHI IN THIS FORM.

Doctor's/Practitioner's Name and Specialty:

Dr. John Joe MD, Endocrinologist

Patient name:

First Name

Last Name

Patient email:

How did you hear about us?

I, the patient, give my full consent to be referred to Eat For Health LLC, and to share my protected health information with them for the purpose of treatment.

I consent