Pre-Registration Forms

Download, fill in and bring with you at your scheduled visiting time.

Deborah Jeffery, RDN, LD

Registered Licensed Dietitian Nutritionist

Office Contacts:

  • 1800 Michael Faraday Dr. Suite 201
    Reston, VA. 20190

  • 2501 N. Glebe Rd. Suite 303
    Arlington, VA. 22207

  • PHONE: (703) 201 - 1184

Appointments: Scheduling Made EASY!


Fairfax Dietetics understands a busy lifestyle! We are geared to providing the best nutritional counseling experience for your appointed time. Through our quick and easy online appointment form, Live Chat and pre-registration form downloads, you’ll be successfully registered in our system – and then we can spend MORE time on your visit and our conversations.

Within our website you have the availability to connect with us and let us know what schedules fit you best. Sometimes we even have same day scheduling – including after hours and available weekends. Simply fill in the pre-registration form and check off your availability and we’ll try to schedule around it.

Who Knew? But it’s definitely worth giving this option a try! We’ve found that many of our clients like this availability for instant access to questions and answers. If you have a device with a web cam or can easily access GO To Meeting, we can have our scheduled appointment on-line! All you have to do is fill in the pre-register form and check off that you’d prefer a Virtual Appointment. Or simply click Live Chat within the website and have a quick chat for scheduling.

appointments Whether you are a first-time patient or a returning patient, please contact us before you arrive to pre-register for your visit. Likewise, we’ll make every effort to remind you of your pre-scheduled time with us.

Scheduling Policy: In the event you are unable to meet your scheduled appointment in-office or virtually, we require a 24 HOUR NOTICE. If you do not meet this requirement we will invoice for the time to the registrant’s billing address on the form.

Payments: Fairfax Dietetics accepts most major credit and health saving account cards as well as PayPal® instant payments for our Virtual Nutritional Counseling. We also accept personal checks and cash. Payment is due at time of service. We do not process insurance claims but we can provide you with a medically coded receipt for you to submit to your insurance company for reimbursement.

Fairfax Dietetics All rights Reserved. Copyright © 2014-