Clinical Hub,Patient Education,Health and Nutrition Facts For You,Nutrition

Nutrition Referral: Nutrition Follow-up Plan (227)

Nutrition Referral: Nutrition Follow-up Plan (227) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Nutrition


Nutrition Follow-up Plan

Patient Name __________________________________________Date ____________________________

Referring Registered Dietitian ___________________________ Clinic ___________________________

Suggestions for Nutrition Therapy _________________________________________________________

Based on our talk today, further nutrition education and work with a registered dietitian would be helpful in
meeting your health goals. Working with a specialist on these areas may be helpful to your success:


A UW Health Clinical Nutrition scheduling assistant will contact you to help schedule your
next appointment.

If you are a UW Health patient and have more questions please contact UW Health at one of the phone
numbers listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s
Hospital (AFCH) can be reached at: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770.

Your health care team may have given you this information as part of your care. If so, please use it and call if you have any
questions. If this information was not given to you as part of your care, please check with your doctor. This is not medical advice.
This is not to be used for diagnosis or treatment of any medical condition. Because each person’s health needs are different, you
should talk with your doctor or others on your health care team when using this information. If you have an emergency, please call
911. Copyright © 2/2017 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Clinical
Nutrition Services Department and the Department of Nursing. HF#227