New Patient Forms

Please download and print the following new patient forms.  Complete and bring them with you to your first appointment. If your appointment is via phone or Skype, please fax the completed forms to 516-486-1792 at least 24 hours before your scheduled appointment.

For Individual Nutrition Counseling

Patient Registration
Medical History
Informed Consent Form
Office Policy
Privacy Practices Acknowledgement

Click here to view HIPAA Policy

For Group/Family Nutrition Counseling

Family Nutrition History Questionnaire (plus Informed Consent, Office Policy and Privacy Practices Acknowledgment forms above)

Can’t read PDF’s? Download Acrobat Reader software for free here.


“I’ve been working with Bonnie for a few months now and I feel great!  After years of dieting and struggling with my weight, I’ve come to realize that losing weight is much easier than I ever imagined it would be.  I learned that dieting is not the answer and that the key to success is simply a combination of exercise and learning how to eat healthy.  Thank you Bonnie for guiding me to a healthier lifestyle and for showing me the way to success.  Slow and steady wins the race!”
—Rebecca, West Hempstead, N.Y.