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Patient Info:
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Click on the links below to download the forms you need.
Authorization for Release of Information
Diet Record Diabetes
Diet Record
Directions for Recording Food Intake
Food Frequency Checklist
New Patient Information
Nutrition Assessment Form
Patient Insurance Information
Insurance:
Services may be covered in full or in part by your health insurance or employee benefit plan. Please check your coverage carefully by asking the following questions:
* Do I have nutrition benefits?
* What is my deductible and has it been met?
* How many nutrition sessions does my plan cover?
* How much does my plan cover for an out-of-network provider?
* What is the coverage amount for each nutrition session?
* Is a referral needed from my primary care physician?
Payment:
Cash, checks and credit card accepted for payment.
Cancellation Policy:
If you do not show up for your scheduled appointment, and you have not notified us at least 24 hours in advance, you will be required to pay the full cost of the treatment as booked.
Contact/Schedule an Appointment:
Questions? Please contact us for further information.
Presentations:
Local - $750/hour
Out of NYC - $1500/day (Plus expenses and travel time)
Nutrition Consultations:
Initial nutrition appointment - $250
Follow-up appointment:
30 minutes - $75
60 minutes - $150
Package (4 x 20 minute appts.) - $200
Testing:
Body Composition Analysis - $100 (Includes a 30 minute consultation)
Diet analysis - $150
Resting Metabolic Test - $150
Fitness assessment, individualized exercise program
with computer handout plus one hour training session - $350
Personal Training:
Lift Gym - $115/hr
In home, upper eastside - $150/hr
Other parts of city - $100/hr + travel time
Payment:
Cash, checks and credit cards accepted for payment.
Cancellation Policy:
If you do not show up for your scheduled appointment, and you have not notified us at least 24 hours in advance, you will be required to pay the full cost of the treatment as booked.
Contact/Schedule an Appointment:
Questions? Please contact us for further information.
Mary Jane Detroyer, MS, RD, CDN
357 East 57th Street, Suite 14B
New York, NY 10022
T: 212-759-7110
F:212-759-7113
E: mjdetroyer@usa.net
Meredith Liss, MA, RD, CDN, CDE
Lift Gym
139 E. 57th Street, 9th Floor
New York, NY 10022
T: 646-322-6521
F: 212-759-7110
E: meredithliss@aol.com
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