Pre-Registration Forms

Download and bring with you at your scheduled visit.
Deborah Jeffery, RDN LD Registered, Licensed Dietitian Nutritionist

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.

In-Office Appointments: 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.

Virtual Appointments: 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.

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 cards as well as PayPal® instant payments for our Virtual Nutritional Counseling.

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