For Patients
Client Forms
Adult Medical Questionnaire
Adult Medical Questionnaire Supplement
Medical Symptoms Questionnaire
24 Hour Cancellation
Release of Information
NOTE: These forms will be provided via email once we have made contact (504-451-0998).
Phone Calls and Text Messages
After a paid consultation, phone calls or texts under 5 minutes (and not frequent) will be responded to. More than 5 minutes will result in a fee based on 15 minute increments. Please refer to Jan’s Service Agreement.
Medical Disclaimer
Please CLICK HERE to read Jan’s medical disclaimer.
Visit
Location:
4322 Canal St.
New Orleans, La 70119
504-451-0998
Insurance Coverage
JAN DOES NOT BILL FOR INSURANCE. She will provide you with the form(s) necessary to submit to your insurance carrier should you decide to seek reimbursement from your provider. This does not guarantee that you will receive reimbursement.
NOTE: Jan is not a physician and therefore cannot provide you with a diagnosis code. You must obtain that from your physician.
It is your responsibility to check with your insurance carrier prior to our visit to ascertain coverage and required conditions for reimbursement of Jan’s services. If you have a medical condition, your insurance carrier may reimburse you for nutrition services but conditions for reimbursement variety greatly from one provider to the next.
Cancellation Policy
When you set an appointment with Jan W Johnson, RDN, LDN it is your responsibility to keep that appointment and be timely.
If you need to cancel your appointment it must be done within 24 hours of your appointment by phone or text only at 504-451-0998.
EMAIL CANCELLATIONS ARE NOT VALID.
If you do not provide 24 hours notice you will be charged the full amount of your scheduled visit.
Calls/texts requiring more than 5 minutes of my time will result in a charge base on for 15 minute increments ($35).