SOUND DIETITIANS LLC
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Financial Agreement

It is the patient’s responsibility to check insurance benefits and coverage.  You will be responsible for any non-covered services, deductibles, co-payments or co-insurances, as determined by your insurance carrier.  Accounts unpaid by the insurance carrier greater than 90 days will be billed to the patient. Payments can be made via cards, such as  credit/debt/FSA/HSA, or cash or check.  There is a $35 fee for all returned checks.  Cash-rate visit payments are due prior to your appointment. 


Cancellation Policy

We request 24 hour notice for cancellation of appointments. Late cancellation or missed appointments are charged at $30.  Please note that insurance companies will not cover missed appointment charges and, thus, this expense would be out-of-pocket for the patient.

Financial Agreement & Cancellation Policy Signature Form 

HIPAA Privacy Policy

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Patient HIPAA Signature Form
Providing Expert Nutrition Services to the Greater Puget Sound Region. 
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  • HOME
  • About
    • Philosophy
    • Our Team
    • Locations
    • Telehealth
  • Work With Us
    • Nutrition Counseling
    • Diabetes Education
    • Clinics & Businesses
    • Dietitians & Interns
    • Contact
  • Blog
  • Giving & Receiving