Need a Referral?

If you are covered by BCBS Texas, Ambetter/Superior Health or United Healthcare, you may need a referral before you are seen; however, having a referral does not guarantee coverage for a visit. It is always best to check with your insurance beforehand. 

Please click on the link for a nutrition referral for your primary care physician physician or specialist to complete. You do not have to have an appointment with your physician to have this form completed. It can be sent to his/her office and signed without you being present. 


After completion, it can be emailed, faxed or brought with you to your appointment. 

Email: [email protected]

Fax: 817-476-6133