Ann Litt - Eating Well on Campus
Elkview Drive 1799
Jensen Beach, FL 33457
Phone: 772-334-0696

Be Your Own Boss Starter Kit

This is an ideal resource for any dietetic professional considering private practice.
By Ann S. Litt, MS, RD and Faye Berger Mitchell, RD

Now available on disc. 21 printer ready forms you need to start a private practice including

  • superbilloffice management forms
  • patient assessment tools
  • see complete list

Read Details
Reader Comments
Complete List of Forms

SAVE TIME - don't reinvent the wheel

$100.00 - an investment that will save your time setting up your private practice.


Book Details

Step-by-step kit with everything you need TO GET STARTED!! Over 17 forms designed for you to easily personalize with your logo if desired.

The office start up and management forms are needed to help in running your office smoothly. Includes insurance coverage form, HIPAA form, superbill form, patient registration form, daily accounting summary and much more.

The most requested form is the superbill. It has been customized to reflect the most common diagnoses used by dietitians (coded with the most current ICD-9 codes). Options for services include current MNT codes.

The dietitian tools include three different methods for a diet intake form, a food history and assessment form, progress note form and much more.

See below for complete list.

List of Ready-to-Go Forms

Topics cover insurance coverage, HIPAA, superbill form, patient registration, daily accounting summary and much more.

  • Superbill
  • Steps for Setting up an Office Checklist
  • Insurance Coverage for Nutrition Services
  • Patient Registration Form
  • New Patient Information Sheet
  • Fax Cover Sheet
  • Sample Introduction Letter to Referral Sources
  • Sample Referral Report
  • Authorization for Release of Information
  • HIPAA Acknowledgement Form
  • Daily Accounting Summary
  • Telephone Intake Sheet
  • Food Journal
  • Diet Intake Forms
  • Food History Questionnaire and Assessment Forms – adult and pediatric version
  • Dietitian Summary Form
  • Progress Note Form
  • Instructions for Completing a Food Journal
  • Nutrition Progress Note
  • Medical Nutrition Therapy Form

Reader Comments
Here's what readers are saying about Be Your Own Boss Starter Kit

  • "It saved me hours of time… I did not have to reinvent the wheel.”

    Beverly Clayshulte, MS, LN
  • “The forms saved me valuable time and money. It makes my life easier.”

Cindy Cassel, RD

  • "You cannot be in private practice without these."

Registered Dietitian

Eating Well on Campus