Client Forms
Your consultation may be eligible for reimbursement from insurance.
How?
- Before your consultation with a dietitian, ask your doctor to fax a referral form with a diagnosis code to your Victorem team practitioner.
- Schedule your consultation.
- After your consultation, submit your receipt to insurance.
Victorem does not guarantee insurance reimbursement. Services must be paid in full before submitting your claim to insurance.
Resources
- Referral form for healthcare providers to fill out and fax.
- Explanation of superbill (consultation receipt)
Fax referrals to 979-227-1188
